Diagnosis of lung cancer following emergency admission: Examining care pathways, clinical outcomes, and advanced NSCLC treatment in an Italian cancer Center

被引:2
作者
Vallome, Giacomo [1 ]
Cafaro, Iacopo [2 ]
Bottini, Annarita [3 ]
Dellepiane, Chiara [4 ]
Rossi, Giovanni [4 ]
Bennicelli, Elisa [4 ]
Parisi, Francesca [4 ]
Zullo, Lodovica [4 ]
Tagliamento, Marco [3 ]
Ballestrero, Alberto [2 ,3 ]
Barisione, Emanuela [5 ]
Piroddi, Ines Maria Grazia [5 ]
Montecucco, Fabrizio [6 ,7 ]
Carbone, Federico [6 ,7 ]
Pronzato, Paolo [4 ]
Lambertini, Matteo [3 ,8 ]
Spagnolo, Francesco [4 ,9 ]
Barletta, Giulia
Barcellini, Lucrezia [4 ]
Ferrante, Michele [4 ]
Nardin, Simone [4 ]
Coco, Simona [10 ,11 ]
Marconi, Silvia [10 ]
Zinoli, Linda [3 ,8 ,9 ]
Moscatelli, Paolo [11 ]
Arboscello, Eleonora [12 ]
Del Mastro, Lucia [3 ,8 ]
Bellodi, Andrea [2 ]
Genova, Carlo [2 ,3 ,8 ,9 ]
机构
[1] Osped Padre Antero Micone, UO Oncol Med, ASL3, Genoa, Italy
[2] IRCCS Osped Policlin San Martino, UO Clin Med Interna Indirizzo Oncol, Genoa, Italy
[3] Univ Genoa, Sch Med, Dept Internal Med & Med Specialties DiMI, Genoa, Italy
[4] IRCCS Osped Policlin San Martino, UO Oncol Med 2, Genoa, Italy
[5] IRCCS Osped Policlin San Martino, UO Pneumol Indirizzo Interventist, Genoa, Italy
[6] Univ Genoa, Dept Internal Med, Clin Internal Med 1, Genoa, Italy
[7] IRCCS Osped Policlin San Martino, Italian Cardiovasc Network, Genoa, Italy
[8] IRCCS Osped Policlin San Martino, UO Clin Oncol Med, Genoa, Italy
[9] Univ Genoa, Dept Surg Sci & Integrated Diagnost DISC, Plast Surg Div, Genoa, Italy
[10] IRCCS Osped Policlin San Martino, UO Tumori Polmonari, Genoa, Italy
[11] IRCCS Osped Policlin San Martino, UO Med Interna, Genoa, Italy
[12] IRCCS Osped Policlin San Martino, Dipartimento Emergenza Urgenza & Accettaz DEA, Genoa, Italy
关键词
Lung cancer; Cancer diagnosis; Performance status; Molecular characterization; Emergency department; SURVIVAL; PATTERNS; BREAST;
D O I
10.1016/j.heliyon.2023.e21177
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: Lung cancer patients diagnosed following emergency admission often present with advanced disease and poor performance status, leading to suboptimal treatment options and outcomes. This study aimed to investigate the clinical and molecular characteristics, treatment initiation, and survival outcomes of these patients. Methods: We retrospectively analyzed data from 124 patients diagnosed with lung cancer following emergency admission at a single institution. Clinical characteristics, results of molecular analyses for therapeutic purpose, systemic treatment initiation, and survival outcomes were assessed. Correlations between patients' characteristics and treatment initiation were analyzed. Results: Median age at admission was 73 years, and 79.0 % had at least one comorbidity. Most patients (87.1 %) were admitted due to cancer-related symptoms. Molecular analyses were performed in 89.5 % of advanced non-small cell lung cancer (NSCLC) cases. In this subgroup, twothirds (66.2 %) received first-line therapy. Median overall survival (OS) was 3.9 months for the entire cohort, and 2.9 months for patients with metastatic lung cancer. Among patients with advanced NSCLC, OS was significantly longer for those with actionable oncogenic drivers and those who received first-line therapy. Improvement of performance status during hospitalization resulted in increased probability of receiving first-line systemic therapy. Discussion: Patients diagnosed with lung cancer following emergency admission demonstrated poor survival outcomes. Treatment initiation, particularly for patients with actionable oncogenic drivers, was associated with longer OS. These findings highlight the need for proactive medical approaches, including improving access to molecular diagnostics and targeted treatments, to optimize outcomes in this patient population.
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页数:10
相关论文
共 25 条
[1]  
AIOM-Istituto Superiore di Sanita Linee Guida, 2024, AIOM-Neoplasie del Polmone
[2]   Pathways to the diagnosis of lung cancer in the UK: a cohort study [J].
Barrett, Jacqueline ;
Hamilton, William .
BMC FAMILY PRACTICE, 2008, 9 (1)
[3]   Risk factors and survival outcome for non-elective referral in non-small cell lung cancer patients - Analysis based on the National Lung Cancer Audit [J].
Beckett, P. ;
Tata, L. J. ;
Hubbard, R. B. .
LUNG CANCER, 2014, 83 (03) :396-400
[4]   A NEW METHOD OF CLASSIFYING PROGNOSTIC CO-MORBIDITY IN LONGITUDINAL-STUDIES - DEVELOPMENT AND VALIDATION [J].
CHARLSON, ME ;
POMPEI, P ;
ALES, KL ;
MACKENZIE, CR .
JOURNAL OF CHRONIC DISEASES, 1987, 40 (05) :373-383
[5]  
Collett D., 2023, Modelling Survival Data in Medical Research
[6]   Routes to diagnosis for cancer - determining the patient journey using multiple routine data sets [J].
Elliss-Brookes, L. ;
McPhail, S. ;
Ives, A. ;
Greenslade, M. ;
Shelton, J. ;
Hiom, S. ;
Richards, M. .
BRITISH JOURNAL OF CANCER, 2012, 107 (08) :1220-1226
[7]   compound.Cox: Univariate feature selection and compound covariate for predicting survival [J].
Emura, Takeshi ;
Matsui, Shigeyuki ;
Chen, Hsuan-Yu .
COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE, 2019, 168 :21-37
[8]   Analysis of advanced lung cancer patients diagnosed following emergency admission [J].
Fujimoto, Daichi ;
Shimizu, Ryoko ;
Morimoto, Takeshi ;
Kato, Ryoji ;
Sato, Yuki ;
Kogo, Mariko ;
Ito, Jiro ;
Teraoka, Shunsuke ;
Otoshi, Takehiro ;
Nagata, Kazuma ;
Nakagawa, Atsushi ;
Otsuka, Kojiro ;
Katakami, Nobuyuki ;
Tomii, Keisuke .
EUROPEAN RESPIRATORY JOURNAL, 2015, 45 (04) :1098-1107
[9]   New systemic strategies for overcoming resistance to targeted therapies in non-small cell lung cancer [J].
Genova, Carlo ;
Rijavec, Erika ;
Biello, Federica ;
Rossi, Giovanni ;
Barletta, Giulia ;
Dal Bello, Maria Giovanna ;
Vanni, Irene ;
Coco, Simona ;
Alama, Angela ;
Grossi, Francesco .
EXPERT OPINION ON PHARMACOTHERAPY, 2017, 18 (01) :19-33
[10]   CANCER PRESENTATION IN THE EMERGENCY DEPARTMENT - A FAILURE OF PRIMARY CARE [J].
HARGARTEN, SW ;
ROBERTS, MJS ;
ANDERSON, AJ .
AMERICAN JOURNAL OF EMERGENCY MEDICINE, 1992, 10 (04) :290-293