Oncologic Emergencies: The Emergency Care of Cancer Patients

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Survivorship and Quality of Life".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 3171

Special Issue Editors


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Guest Editor
Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Interests: oncologic emergencies; venous thromboembolisms; immunotherapy adverse events; sepsis; biomedical informatics

E-Mail Website
Guest Editor
Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Interests: oncologic emergencies; sepsis; neutropenic fever; thromboembolism; biomarkers; immune-related adverse events; machine learning

Special Issue Information

Dear Colleagues,

As the number of patients with active cancer is expected to increase, so are visits to the emergency departments and other high-acuity urgent care facilities. Considering the complexity of the presented emergency problems caused by cancer, antineoplastic treatments, and comorbidities, the proper diagnosis and management of oncologic emergencies are vital to addressing the root causes to prevent or minimize any morbidities and mortalities related to these emergency encounters. This Special Issue focuses on common conditions among cancer patients in emergency departments and other urgent care centers. These conditions include, but are not limited to, the following: 1) infection, sepsis, and febrile neutropenia; 2) treatment-related adverse events of cytotoxic chemotherapy, radiotherapy, and immunotherapy; 3) metabolic emergencies, including tumor lysis syndrome and humoral paraneoplastic syndromes; 4) cancer-related complications including venous thromboembolism, malignant spinal cord compression, thoracoabdominopelvic viscus obstructions, and superior vena cava syndrome; and 5) cancer pain.

Dr. Aiham Qdaisat
Prof. Dr. Sai-Ching Jim Yeung
Guest Editors

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Keywords

  • emergency
  • cancer
  • oncologic emergencies
  • infections
  • sepsis
  • adverse events
  • venous thromboembolism
  • tumor lysis syndrome
  • febrile neutropenia
  • paraneoplastic syndromes
  • spinal cord compression
  • obstruction
  • cancer pain
  • metabolic emergencies
  • superior vena cava syndrome

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Published Papers (2 papers)

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11 pages, 1684 KiB  
Article
Survival Benefit of Renin-Angiotensin System Blockers in Critically Ill Cancer Patients: A Retrospective Study
by Driss Laghlam, Anis Chaba, Matthias Tarneaud, Julien Charpentier, Jean-Paul Mira, Frédéric Pène and Clara Vigneron
Cancers 2023, 15(12), 3183; https://doi.org/10.3390/cancers15123183 - 14 Jun 2023
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Abstract
Increasing evidence argues for the promotion of tumorigenesis through activation of the renin-angiotensin system pathway. Accordingly, a benefit of renin-angiotensin system blockers (RABs) treatments has been suggested in patients with solid cancers in terms of survival. We aimed to evaluate in-ICU survival and [...] Read more.
Increasing evidence argues for the promotion of tumorigenesis through activation of the renin-angiotensin system pathway. Accordingly, a benefit of renin-angiotensin system blockers (RABs) treatments has been suggested in patients with solid cancers in terms of survival. We aimed to evaluate in-ICU survival and one-year survival in cancer patients admitted to the ICU with respect to the use of RABs. We conducted a retrospective observational single-center study in a 24-bed medical ICU. We included all solid cancer patients (age ≥ 18 years) requiring unplanned ICU admission. From 2007 to 2020, 1845 patients with solid malignancies were admitted (median age 67 years (59–75), males 61.7%). The most frequent primary tumor sites were the gastrointestinal tract (26.8%), the lung (24.7%), the urological tract (20.1%), and gynecologic and breast cancers (13.9%). RABs were used in 414 patients, distributed into 220 (53.1%) with angiotensin-receptor blockers (ARBs) and 194 (46.9%) with angiotensin-converting enzyme inhibitors (ACEis). After multivariate adjustment, ARBs use (OR = 0.62, 95%CI (0.40–0.92), p = 0.03) and ACEis use (OR = 0.52, 95%CI (0.32–0.82), p = 0.006) were both associated with improved in-ICU survival. Treatment with ARBs was independently associated with decreased one-year mortality (OR = 0.6, 95%CI (0.4–0.9), p = 0.02), whereas treatment with ACEis was not. In conclusion, this study argues for a beneficial impact of RABs use on the prognosis of critically ill cancer patients. Full article
(This article belongs to the Special Issue Oncologic Emergencies: The Emergency Care of Cancer Patients)
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13 pages, 831 KiB  
Systematic Review
Impact of Center Volume on Cardiopulmonary and Mortality Outcomes after Immune-Checkpoint Inhibitors for Cancer: A Systematic Review and Meta-Analysis
by Mohamed Rahouma, Nathan Mynard, Massimo Baudo, Sherif Khairallah, Shaikha Al-Thani, Anas Dabsha, Shon Shmushkevich, Osama Shoeib, Mohamed Hossny, Elsayed Eldeeb, Hala Aziz, Naglaa Abdelkarim, Mario Gaudino, Abdelrahman Mohamed, Leonard Girardi, Jun Zhang and Luciano Mutti
Cancers 2024, 16(6), 1136; https://doi.org/10.3390/cancers16061136 - 13 Mar 2024
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Abstract
Immune-checkpoint inhibitors (ICIs) were proven effective in inducing tumor regression. However, its toxicity tends to be fatal. We sought to investigate the hospital volume/outcomes relationship. Databases were searched for studies reporting immune-checkpoint inhibitors adverse events (AEs) in patients with solid-organ malignancies. The outcomes [...] Read more.
Immune-checkpoint inhibitors (ICIs) were proven effective in inducing tumor regression. However, its toxicity tends to be fatal. We sought to investigate the hospital volume/outcomes relationship. Databases were searched for studies reporting immune-checkpoint inhibitors adverse events (AEs) in patients with solid-organ malignancies. The outcomes were A) the pooled events rate (PER) of grade 5, grade 3–4, cardiac-related, and pulmonary-related AEs, and B) the assessment of the volume/outcomes relationship. One hundred and forty-seven studies met our inclusion criteria. The PER of grade 5, grade 3–4, and any-grade AEs was 2.75% (95%CI: 2.18–3.47), 26.69% (95%CI: 21.60–32.48), and 77.80% (95%CI: 70.91–83.44), respectively. The PER of pulmonary-related AEs was 4.56% (95%CI: 3.76–5.53). A higher number of annual cases per center was significantly associated with reduced grade 5 (p = 0.019), grade 3–4 (p = 0.004), and cardiac-related AEs (p = 0.035) in the meta-regression. In the current era of cancer immunotherapy, knowledge regarding the early diagnosis and management of immunotherapy-related AEs is essential. Our meta-analysis demonstrates the importance of center volume in improving outcomes and reducing the incidence of severe AEs. Full article
(This article belongs to the Special Issue Oncologic Emergencies: The Emergency Care of Cancer Patients)
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