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Prognosis of cancer patients in the intensive care unit

Neil Freedman, MD
Section Editors
Polly E Parsons, MD
Paul J Hesketh, MD
Adrienne G Randolph, MD, MSc
Deputy Editor
Geraldine Finlay, MD


Intensive care unit (ICU) admission may be required in patients with cancer for management of acute illnesses associated with the underlying malignancy or complications of therapy including those associated with hematopoietic cell transplantation (HCT).

Admission to an ICU is a traumatic event for cancer patients and their families. Discussion of the prognosis of cancer patients in the setting of a critical illness is a key factor for making clinical decisions in the ICU. The prognosis of critically-ill patients with cancer and factors that determine their mortality are discussed in this topic.

The prognosis of critically ill patients without cancer who have respiratory failure, renal failure and sepsis are discussed separately. (See "Acute respiratory distress syndrome: Prognosis and outcomes in adults" and "Overview of the management of acute kidney injury in adults", section on 'Prognosis' and "Prevention and management of acute kidney injury (acute renal failure) in children", section on 'Prognosis and outcome of acute kidney injury' and "Sepsis syndromes in adults: Epidemiology, definitions, clinical presentation, diagnosis, and prognosis".)


Patients with malignancy are at risk for acute life-threatening illnesses that require ICU admission. Leukemia and lymphoma are the most common hematologic cancers encountered in the ICU and lung cancer is the most common solid tumor in adults [1]. In addition, as many as 40 percent of allogeneic hematopoietic cell transplant (HCT) recipients develop one or more complications where transfer to an ICU is indicated [2-5].

Indications for ICU admission can be cancer-related (eg, critical organ infiltration, pulmonary embolus), treatment-related (eg, sepsis or drug toxicity) or due to co-morbid illnesses (eg, kidney disease, heart failure, chronic obstructive pulmonary disease [COPD] exacerbation). However, consistently, the most common reason for ICU admission in cancer patients is acute organ failure, usually one or more of the following [2-4,6-23]:

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Literature review current through: Nov 2017. | This topic last updated: Mar 02, 2017.
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