Supplementary Material for: Long-Term Outcomes and Prognostic Factors of Patients with Metastatic Solid Tumors Admitted to the Intensive Care Unit

<b><i>Introduction:</i></b> Admission of metastatic cancer patients to the intensive care unit (ICU) poses medical and ethical challenges in the absence of reliable prognostic tools to guide decision-making. <b><i>Material and Methods:</i></b> We retrospectively analyzed the medical charts of 129 consecutive patients with metastatic solid tumors admitted to the ICU between January and September 2014 and identified prognostic factors (PFs) using Cox models. <b><i>Results:</i></b> The mean patient age at ICU admission was 58.9 years (range, 25–81 years; males, 51%). Performance status (PS) was 0–1 and 2–3 in 61% and 39% of the patients, respectively. The most prevalent cancers were lung cancer (20%), sarcoma (17%), and breast cancer (16%). ICU admission was attributable to the cancer itself (53%), cancer treatment toxicity (43%), and comorbidities (37%). The median overall survival (OS) after ICU admission was 2.6 months; 15% of the patients died during the ICU stay. Poor PFs for OS were PS &gt;1 before ICU admission (<i>p</i> = 0.007) and ICU admission for the cancer itself (<i>p</i> &lt; 10⁻³). After ICU discharge, 58% and 42% of the patients received systemic treatment within 12 months and showed good PS recovery, respectively. Multiple organ failure and a multidisciplinary decision to limit therapeutic efforts were poor PFs for reinitiation of systemic treatment (<i>p</i> = 0.2 and 0.006, respectively), and the latter was also a poor PF for PS recovery (<i>p</i> = 0.004). <b><i>Discussion:</i></b> In the ICU, the OS of adult patients with solid tumors was similar to that of the noncancer population. For ICU admissions related to the cancer itself, the prognosis is poor.

<b><i>引言：</i></b> 在缺乏可靠预后工具以指导临床决策的背景下，转移性癌症患者收入重症监护病房（Intensive Care Unit, ICU）会面临医疗与伦理层面的双重挑战。
<b><i>材料与方法：</i></b> 本研究回顾性分析了2014年1月至9月期间收入ICU的129例连续纳入的实体瘤转移患者的病历资料，并通过Cox模型（Cox models）明确了预后因素（Prognostic Factors, PFs）。
<b><i>结果：</i></b> 患者收入ICU时的平均年龄为58.9岁（年龄范围25~81岁；男性占比51%）。体力状态评分（Performance Status, PS）为0~1分与2~3分的患者占比分别为61%与39%。最常见的癌种依次为肺癌（20%）、肉瘤（17%）与乳腺癌（16%）。本次ICU收治的诱因包括肿瘤本身（53%）、肿瘤治疗相关毒性反应（43%）与合并症（37%）。患者收入ICU后的中位总生存期（Overall Survival, OS）为2.6个月；15%的患者在ICU住院期间死亡。影响总生存期的不良预后因素为ICU收治前体力状态评分＞1分（*P* = 0.007）以及因肿瘤本身收治入ICU（*P* ＜ 10⁻³）。ICU出院后，分别有58%与42%的患者在12个月内接受了全身治疗，且体力状态恢复良好。多器官功能衰竭与限制治疗措施的多学科决策是影响全身治疗重启的不良预后因素（*P* 分别为0.2与0.006），而后者同时也是影响体力状态恢复的不良预后因素（*P* = 0.004）。
<b><i>讨论：</i></b> 成人实体瘤患者在ICU中的总生存期与非癌症人群相近。对于因肿瘤本身收治入ICU的患者，其预后较差。