Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Aug 15, 2025; 17(8): 106688
Published online Aug 15, 2025. doi: 10.4251/wjgo.v17.i8.106688
Intensive care unit outcomes and prognostic factors of esophageal cancer: A cross-sectional study in Chinese cancer-specialized hospitals
Jiang-Feng Tang, Rui Xia, Xue-Zhong Xing, Chang-Song Wang, Gang Ma, Hong-Zhi Wang, Biao Zhu, Jiang-Hong Zhao, Dong-Min Zhou, Li Zhang, Ming-Guang Huang, Rong-Xi Quan, Yong Ye, Guo-Xing Zhang, Zheng-Ying Jiang, Bing Huang, Shan-Ling Xu, Yun Xiao, Lin-Lin Zhang, Rui-Yun Lin, Shu-Liang Ma, Yu-An Qiu, Zhen Zheng, Ni Sun, Le-Wu Xian, Ji Li, Ming Zhang, Zhi-Jun Guo, Yong Tao, Xiang-Zhe Zhou, Wei Chen, Dao-Xie Wang, Ji-Yan Chi, Dong-Hao Wang, Kai-Zhong Liu
Jiang-Feng Tang, Kai-Zhong Liu, Department of Intensive Care Unit, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine, Chinese Academy of Sciences, Hangzhou 310000, Zhejiang Province, China
Rui Xia, Dong-Hao Wang, Department of Intensive Care Unit, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300000, China
Xue-Zhong Xing, Department of Intensive Care Unit, Cancer Hospital Chinese Academy of Medical Sciences, Beijing 100021, China
Chang-Song Wang, Department of Intensive Care Unit, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
Gang Ma, Department of Intensive Care Unit, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
Hong-Zhi Wang, Department of Intensive Care Unit, Beijing Cancer Hospital, Beijing 100000, China
Biao Zhu, Department of Intensive Care Unit, Fudan University Affiliated Shanghai Cancer Hospital, Shanghai 200000, China
Jiang-Hong Zhao, Department of Intensive Care Unit, Hunan Cancer Hospital, Changsha 410000, Hunan Province, China
Dong-Min Zhou, Department of Intensive Care Unit, Henan Cancer Hospital, Zhengzhou 450000, Henan Province, China
Li Zhang, Department of Intensive Care Unit, Hubei Cancer Hospital, Wuhan 430000, Hubei Province, China
Ming-Guang Huang, Department of Intensive Care Unit, Shanxi Province Cancer Hospital, Taiyuan 030000, Shanxi Province, China
Rong-Xi Quan, Department of Intensive Care Unit, Cancer Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
Yong Ye, Department of Intensive Care Unit, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou 350014, Fujian Province, China
Guo-Xing Zhang, Department of Intensive Care Unit, Gaoxin District of Jilin Cancer Hospital, Changchun 130000, Jilin Province, China
Zheng-Ying Jiang, Department of Intensive Care Unit, Chongqing University Cancer Hospital, Chongqing 400000, China
Bing Huang, Department of Intensive Care Unit, Guangxi Medical University Affiliated Tumor Hospital, Nanning 530000, Guangxi Zhuang Autonomous Region, China
Shan-Ling Xu, Department of Intensive Care Unit, Sichuan Cancer Hospital and Institute, Chengdu 610041, Sichuan Province, China
Yun Xiao, Department of Intensive Care Unit, Yunnan Cancer Hospital, Kunming 650000, Yunnan Province, China
Lin-Lin Zhang, Department of Intensive Care Unit, Anhui Province Cancer Hospital, Hefei 230001, Anhui Province, China
Rui-Yun Lin, Department of Intensive Care Unit, Cancer Hospital of Shantou University Medical College, Shantou 515000, Guangdong Province, China
Shu-Liang Ma, Department of Intensive Care Unit, Jiangsu Cancer Hospital, Nanjing 210000, Jiangsu Province, China
Yu-An Qiu, Department of Intensive Care Unit, Jiangxi Provincial Tumor Hospital, Nanchang 330000, Jiangxi Province, China
Zhen Zheng, Department of Intensive Care Unit, Liaoning Cancer Hospital and Institute, Shenyang 110000, Liaoning Province, China
Ni Sun, Department of Intensive Care Unit, Huguang District of Jilin Cancer Hospital, Changchun 130000, Jilin Province, China
Le-Wu Xian, Department of Intensive Care Unit, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
Ji Li, Department of Intensive Care Unit, Hainan Cancer Hospital, Haikou 570000, Hainan Province, China
Ming Zhang, Department of Intensive Care Unit, Hangzhou Cancer Hospital, Hangzhou 310000, Zhejiang Province, China
Zhi-Jun Guo, Department of Intensive Care Unit, Shandong First Medical University Affiliated Tumor Hospital, Jinan 300000, Shandong Province, China
Yong Tao, Department of Intensive Care Unit, Nantong Tumor Hospital, Nantong 256000, Jiangsu Province, China
Xiang-Zhe Zhou, Department of Intensive Care Unit, Gansu Provincial Cancer Hospital, Lanzhou 730000, Gansu Province, China
Wei Chen, Department of Intensive Care Unit, Beijing Shijitan Hospital (Capital Medical University Cancer Hospital), Beijing 100000, China
Dao-Xie Wang, Department of Intensive Care Unit, Cancer Hospital of Zhengzhou, Zhengzhou 450000, Henan Province, China
Ji-Yan Chi, Department of Intensive Care Unit, Tumor Hospital of Mudanjiang City, Mudanjiang 157000, Heilongjiang Province, China
Author contributions: Tang JF and Xia R contributed to the conceptualization and methodology of this manuscript; Xing XZ, Wang CS, Ma G, Wang HZ, Zhu B, Zhao JH, Zhou DM, Zhang L, Quan RX, Ye Y, Zhang GX, Jiang ZY, Huang B, Xu SL, Lin RY, Ma SL, Sun N, Zhang M, Guo ZJ, Zhou XZ, Chen W, and Wang DX participated in the data curation; Xing XZ, Wang CS, Wang HZ, Zhao JH, Zhou DM, Quan RX, Zhang GX, Huang B, Zhang LL, Lin RY, Ma SL, Zheng Z, Sun N, Li J, Zhang M, Guo ZJ, Tao Y, Zhou XZ, Chen W, Wang DX, and Chi JY were involved in the formal analysis; Ma G, Zhu B, Zhang L, Huang MG, Ye Y, Jiang ZY, Xu SL, Xiao Y, Zhang LL, Qiu YA, Zheng Z, Xian LW, Li J, Tao Y, and Chi JY contributed to the investigation; Huang MG, Xiao Y, Qiu YA, and Xian LW participated to the resources; Wang DH and Liu KZ contributed to the project administration, writing - original draft, and writing - review & editing. Wang DH and Liu KZ contributed equally to this manuscript as co-corresponding authors. All authors have read and approved the final work.
Institutional review board statement: This study was approved by Ethic Committee of Tianjin Medical University Cancer Institute and Hospital (No. bc2021065). This study adheres to the Declaration of Helsinki.
Informed consent statement: Written informed consent was obtained from participations and their parents.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kai-Zhong Liu, Department of Intensive Care Unit, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine, Chinese Academy of Sciences, No. 1 East Banshan Road, Gongshu District, Hangzhou 310000, Zhejiang Province, China. liukaizhongicu@126.com
Received: March 5, 2025
Revised: March 26, 2025
Accepted: June 25, 2025
Published online: August 15, 2025
Processing time: 162 Days and 17.1 Hours
Abstract
BACKGROUND

Esophageal cancer patients had the highest intensive care unit (ICU) admitted rate in cancer patients. But their prognosis and evaluation methods were rarely studied.

AIM

To depict the short-term mortality outcome and identify the potential prognostic factors of esophageal cancer patients admitted into ICU.

METHODS

A multicenter cross-sectional study was performed from May 10, 2021 to July 10, 2021 at ICU departments of 37 cancer specialized hospitals in China. Patients aged ≥ 14 years with ICU duration ≥ 24 hours were included. Clinical records of patients with primary esophageal cancer diagnosis were reviewed. Patients were separated into groups according to the 90 days survival. Characteristics between groups were compared. Single and multi-variate regression tests were applied to analyze the correlated factors of ICU outcomes. Predictive values of disease severity scores were assessed using receiver operating characteristic curve analysis.

RESULTS

Total 180 esophageal cancer patients were included. The 90 days mortality was 22.2%. Patients with mortality outcome showed differences from those survived mostly in disease severity and unplanned transfer from clinical ward. The current evaluation tools, including Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation II scores had low accuracy in prediction of short-term death. ICU admitted esophageal cancer patients have poor prognosis, especially those with acute illness.

CONCLUSION

The prognostic tools for these patients need to be further optimized.

Keywords: Intensive care unit; Prognostic factors; Esophageal cancer; Chinese cancer-specialized hospitals; Short-term mortality; Disease severity scores

Core Tip: Esophageal cancer patients have the highest intensive care unit admission rate among cancer types but limited prognostic data. This multicenter study in Chinese cancer-specialized hospitals found a 90-day mortality of 22.2%, especially high in patients with acute illness. Existing severity scores showed poor predictive performance, highlighting the need for optimized prognostic tools.