Oncological emergencies in lung cancer patients during 2019 and SARS-CoV-2 pandemic year

ABSTRACT

Lung cancer (LC) is frequently related to oncological emergencies (OE). We performed a retrospective analysis to characterize OE in LC from 2019 to 2020 and to determine the effects of SARS-CoV-2 pandemic. T-test or Mann- Whitney was used to compare independent continuous variables. Comparison between proportions was tested through Chi-square. The association between clinical variables and 6-months mortality was tested through uni and multivariable logistic regression.82 patients were admitted due to OE. The median age was 66 years old and 73.1% were male. The two most frequent OE were brain metastasis (45.1%) and vena cava syndrome (15.8%). OE was the first manifestation of LC in 45.2% of cases and only 24.4% were alive 6 months after the OE. Neurological OE was associated with lower risk of 6-months mortality compared to cardiovascular and respiratory OE, regardless of gender, age, stage, histology, smoking status and cancer treatment [OR 0.255 (CI 0.72-0.90), p=0.035)]. SCLC had shorter time between diagnosis and OE compared to NSCLC (p=0.016), as well as patients with distant metastasis compared to local disease (p=0.02) and in those without previous cancer treatment (p<0.001). When comparing patients admitted with OE in 2019 and 2020, there were no differences in the following variables 6-months mortality (p=0.741), OE as first manifestation of LC (p=0.913), time between diagnosis and OE (p=0.670), stage (p=0.276) and type of OE (p=0.733). In this study, SCLC, metastatic disease and no previous cancer treatment were associated with lesser time until OE and brain metastasis was associated with better prognosis. There were no differences in relevant clinical variables between 2019 and 2020.