Carvalho da Silva Marta Alexandra, Silva Sara Campos, Catarata Maria Joana, Padrão Eva Dias, Ferreira Lurdes
Department of Pulmonology, Braga Hospital, Portugal.
Tanaffos. 2023 Apr;22(4):395-402.
Lung cancer is one of the most frequent neoplasms and is associated with serious oncologic emergencies (OE). We performed a retrospective study to characterize OE in lung cancer patients admitted to the pulmonology department to determine the effects of the SARS-CoV2 pandemic.
A total number of 82 patients were admitted with an emergency, mostly brain metastasis (n=37; 45.1%), followed by superior vena cava syndrome (n=13; 15.9%), cardiac tamponade (n=7; 8.5%), large pleural effusion (n=7; 8.5%), severe pulmonary embolism (n=6; 7.3%), spinal cord syndrome (n=6; 7.3%), massive hemoptysis (n=3; 3.7%), stridor (n=2; 2.4%) and atelectasis (n=1; 1.2%). Clinical and pathological data were retrieved from clinical charts including demographic information, smoking status, cancer histology, clinical stage at diagnosis, anticancer treatment, time between LC diagnosis until the OE, outcomes of OE treatment, and overall survival after OE.
The predominant histology was adenocarcinoma (n=59; 71.9%) and 86.8% of the patients (n=71) were in stage IV. OE was the disease presentation in 45.2% (n=37) and 6-month mortality was 75.6%. Neurologic emergencies were associated with a lower risk of 6-month mortality compared to cardiovascular and respiratory [OR 0.255 (CI 0.72-0.90), p=0.035)]. Younger patients (p=0.011), metastatic disease (p=0.02), no cancer treatment (p<0.001), and small cell carcinoma (SCLC) (p=0.016) had a shorter time between cancer diagnosis and the event.
OE occurred mostly in men with metastatic adenocarcinomas. Younger patients, SCLC, metastatic disease, and no cancer treatment were associated with a shorter time between lung cancer diagnosis until the occurrence of an OE and brain metastasis with a better prognosis. There were no differences between patients admitted in 2019 and 2020 that could be related to the access to healthcare services during the SARS-COV2 pandemic.
肺癌是最常见的肿瘤之一，且与严重的肿瘤急症（OE）相关。我们进行了一项回顾性研究，以描述入住呼吸内科的肺癌患者的肿瘤急症特征，从而确定新型冠状病毒肺炎大流行的影响。
共有82例患者因急症入院，其中大多为脑转移（n = 37；45.1%），其次是上腔静脉综合征（n = 13；15.9%）、心脏压塞（n = 7；8.5%）、大量胸腔积液（n = 7；8.5%）、严重肺栓塞（n = 6；7.3%）、脊髓综合征（n = 6；7.3%）、大量咯血（n = 3；3.7%）、喘鸣（n = 2；2.4%）和肺不张（n = 1；1.2%）。从临床病历中检索临床和病理数据，包括人口统计学信息、吸烟状况、癌症组织学、诊断时的临床分期、抗癌治疗、肺癌诊断至肿瘤急症的时间、肿瘤急症治疗结果以及肿瘤急症后的总生存期。
主要组织学类型为腺癌（n = 59；71.9%），86.8%的患者（n = 71）处于IV期。肿瘤急症是45.2%（n = 37）患者的疾病表现形式，6个月死亡率为75.6%。与心血管和呼吸系统急症相比，神经系统急症的6个月死亡风险较低[比值比0.255（可信区间0.72 - 0.90），p = 0.035]。年轻患者（p = 0.011）、转移性疾病（p = 0.02）、未接受癌症治疗（p < 0.001）和小细胞肺癌（SCLC）（p = 0.016）在癌症诊断至事件发生之间的时间较短。
肿瘤急症大多发生于患有转移性腺癌的男性患者。年轻患者、小细胞肺癌、转移性疾病以及未接受癌症治疗与肺癌诊断至肿瘤急症发生之间的时间较短相关，且脑转移患者预后较好。2019年和2020年入院的患者之间在与新型冠状病毒肺炎大流行期间获得医疗服务相关的方面没有差异。
