Real-world outcomes of metastatic cancer patients hospitalized at initial diagnosis: ONIRIS, a national study

Purpose Therapeutic management of metastatic cancer patients who are hospitalized at the time of initial diagnosis because of impaired performance status and/or severe symptoms is challenging for clinicians. This study aims to describe their outcome.  Methods In this prospective multicentric study,...

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Veröffentlicht in:Supportive care in cancer Jg. 33; H. 2; S. 145
Hauptverfasser: Vercueil, Colin, Varnier, Romain, Seban, Romain, Ciaptacz, Lisa, Pavillet, Julien, Fraisse, Cléa, Darbas, Tiffany, Abdallahoui, Safa, Cox, David, Martin, Sophie, Trensz, Philippe, Kurtz, Jean-Emmanuel, Gantzer, Justine, Amé, Shanti, Bouleuc, Carole, Chvetzoff, Gisèle, Eberst, Lauriane
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2025
Springer Nature B.V
Springer Verlag (Germany)
Schlagworte:
Adult
Aged
Aged, 80 and over
Cancer
Caregivers
Chemotherapy
Comorbidity
Ecology, environment
Female
Health
Hospitalization
Hospitalization - statistics & numerical data
Hospitalized
Humans
Immunotherapy
Inpatient care
Life Sciences
Longitudinal studies
Male
Medical diagnosis
Medical prognosis
Medical treatment
Medicine
Medicine & Public Health
Metastasis
Middle Aged
Neoplasm Metastasis
Neoplasms
Neoplasms - mortality
Neoplasms - pathology
Neoplasms - therapy
Newly diagnosed
Nursing
Nursing Research
Oncology
Pain Medicine
Patient admissions
Patients
Prognosis
Prospective Studies
Rehabilitation Medicine
Santé publique et épidémiologie
Therapy
Tumors
Molecular targeted therapy
Chemotherapy
Metastatic
Prognosis
Immunotherapy
Clinical oncology
ISSN:0941-4355, 1433-7339, 1433-7339
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Zusammenfassung:Purpose Therapeutic management of metastatic cancer patients who are hospitalized at the time of initial diagnosis because of impaired performance status and/or severe symptoms is challenging for clinicians. This study aims to describe their outcome.  Methods In this prospective multicentric study, we included all adult, inpatients with newly diagnosed metastatic solid tumors between November 2021 and May 2022. Patients were followed for 3 months.. Our primary objective was to describe overall survival (OS). Secondary objectives included assessing SANT effectiveness in specific subgroups, identifying baseline factors associated with SANT initiation, and assessing usual prognostic tools and factors associated with response. Results 107 patients were included. Seventy-four (69%) initiated a SANT. Among them, 39 patients were alive at 3 months. Median overall survival was 1.7 months for the entire cohort. Thirty-seven patients (55%) died in the unit where they were first admitted. Patients with chemo-sensitive tumors, such as testicular non-seminomatous germ cell tumors (100% OS at 3 months), or those receiving targeted therapies or hormone therapies (80% OS at 3 months), showed numerically better outcomes. Factors associated with the initiation of a SANT were young age (OR = 0,94 [0,90; 0,98]), low Charlson Comorbidity Index (OR = 0,56 [0,42; 0,73]), and patient’s or caregiver’s request for treatment (respectively, OR = 0,07 [0,02; 0,17] and 0,17 [0,06; 0,42], compared to the respective reference category (no request)). Conclusion Metastatic cancer patients hospitalized at the time of diagnosis share a similar poor survival. Despite the notable exception of chemo-sensitive tumors and specific molecular alterations, the high mortality observed in both groups suggests that SANT has a limited impact on their outcomes. Best supportive care can be reasonably considered for these patients. The benefit of SANT in this altered population should be assessed in larger prospective studies.
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ISSN:0941-4355
1433-7339
1433-7339
DOI:10.1007/s00520-025-09202-5