Heliyon (Nov 2023)

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

  • Giacomo Vallome,
  • Iacopo Cafaro,
  • Annarita Bottini,
  • Chiara Dellepiane,
  • Giovanni Rossi,
  • Elisa Bennicelli,
  • Francesca Parisi,
  • Lodovica Zullo,
  • Marco Tagliamento,
  • Alberto Ballestrero,
  • Emanuela Barisione,
  • Ines Maria Grazia Piroddi,
  • Fabrizio Montecucco,
  • Federico Carbone,
  • Paolo Pronzato,
  • Matteo Lambertini,
  • Francesco Spagnolo,
  • Giulia Barletta,
  • Lucrezia Barcellini,
  • Michele Ferrante,
  • Simone Nardin,
  • Simona Coco,
  • Silvia Marconi,
  • Linda Zinoli,
  • Paolo Moscatelli,
  • Eleonora Arboscello,
  • Lucia Del Mastro,
  • Andrea Bellodi,
  • Carlo Genova

Journal volume & issue
Vol. 9, no. 11
p. e21177

Abstract

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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, two-thirds (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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