title: Outcome analyses after the first admission to an intensive care unit in patients with advanced cancer referred to a phase I clinical trials program.
abstract: OBJECTIVE
  This study assessed outcomes of individuals with advanced cancer who required admission to an intensive care unit (ICU) after referral for an early clinical trial because they did not respond to conventional therapy.
  
  
  METHODS
  Outcome analyses were conducted for 212 consecutive patients admitted to The University of Texas MD Anderson Cancer Center ICU after being seen in the phase I clinic starting on May 1, 2007. All data were obtained by a review of electronic medical records of patients.
  
  
  RESULTS
  The median survival of 212 patients with advanced cancer referred to phase I care after the initial ICU admission was 3.2 weeks (95% CI, 2.5 to 4.9 weeks). Patients who underwent cardiopulmonary resuscitation (CPR) succumbed within a median survival of 1 day (75% and 25% estimated survival of 1 and 3 days, respectively). Patients admitted for a postsurgical intervention did better than patients admitted for a nonsurgical intervention (median survival, 21.5 versus 2.1 weeks; P < .0001). The multivariate analysis revealed that a nonsurgical intervention, hypoalbuminemia, and higher Acute Physiology and Chronic Health Evaluation II scores were associated with poor overall survival.
  
  
  CONCLUSIONS
  The outcome of patients in a phase I clinic after initial ICU admission was poor, particularly when admission was for a nonsurgical intervention and/or when CPR was needed.
authors.affiliation: Department of Investigational Cancer Therapeutics, Unit 0455, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA. siqingfu@mdanderson.org
authors.forename: Siqing
authors.initials: S
authors.lastname: Fu
authors.forename: David S
authors.initials: DS
authors.lastname: Hong
authors.forename: Aung
authors.initials: A
authors.lastname: Naing
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wheler
authors.forename: Gerald
authors.initials: G
authors.lastname: Falchook
authors.forename: Sijin
authors.initials: S
authors.lastname: Wen
authors.forename: Adrienne
authors.initials: A
authors.lastname: Howard
authors.forename: Diane
authors.initials: D
authors.lastname: Barber
authors.forename: Joseph
authors.initials: J
authors.lastname: Nates
authors.forename: Kristen
authors.initials: K
authors.lastname: Price
authors.forename: Razelle
authors.initials: R
authors.lastname: Kurzrock
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D017321:Clinical Trials, Phase I as Topic; D003422:Critical Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D011788:Quality of Life; D012017:Referral and Consultation; D016414:Resuscitation Orders; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013781:Texas