• Matthias Kochanek, Jan Kochanek, Boris Böll, Dennis A Eichenauer, Gernot Beutel, Hendrik Bracht, Stephan Braune, Florian Eisner, Sigrun Friesecke, Ulf Günther, Gottfried Heinz, Michael Hallek, Christian Karagiannidis, Stefan Kluge, Klaus Kogelmann, Pia Lebiedz, Philipp M Lepper, Tobias Liebregts, Catherina Lueck, Ralf M Muellenbach, Matthias Hansen, Christian Putensen, Peter Schellongowski, Jens-Christian Schewe, Kathrin Schumann-Stoiber, Frederik Seiler, Peter Spieth, Steffen Weber-Carstens, Daniel Brodie, Elie Azoulay, and Alexander Shimabukuro-Vornhagen.
• First Department of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center of Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany. Matthias.Kochanek@uk-koeln.de.
• Intensive Care Med. 2022 Mar 1; 48 (3): 332-342.

PurposeThe question of whether cancer patients with severe respiratory failure benefit from veno-venous extracorporeal membrane oxygenation (vv-ECMO) remains unanswered. We, therefore, analyzed clinical characteristics and outcomes of a large cohort of cancer patients treated with vv-ECMO with the aim to identify prognostic factors.Methods297 cancer patients from 19 German and Austrian hospitals who underwent vv-ECMO between 2009 and 2019 were retrospectively analyzed. A multivariable cox proportional hazards analysis for overall survival was performed. In addition, a propensity score-matched analysis and a latent class analysis were conducted.ResultsPatients had a median age of 56 (IQR 44-65) years and 214 (72%) were males. 159 (54%) had a solid tumor and 138 (47%) a hematologic malignancy. The 60-day overall survival rate was 26.8% (95% CI 22.1-32.4%). Low platelet count (HR 0.997, 95% CI 0.996-0.999; p = 0.0001 per 1000 platelets/µl), elevated lactate levels (HR 1.048, 95% CI 1.012-1.084; p = 0.0077), and disease status (progressive disease [HR 1.871, 95% CI 1.081-3.238; p = 0.0253], newly diagnosed [HR 1.571, 95% CI 1.044-2.364; p = 0.0304]) were independent adverse prognostic factors for overall survival. A propensity score-matched analysis with patients who did not receive ECMO treatment showed no significant survival advantage for treatment with ECMO.ConclusionThe overall survival of cancer patients who require vv-ECMO is poor. This study shows that the value of vv-ECMO in cancer patients with respiratory failure is still unclear and further research is needed. The risk factors identified in the present analysis may help to better select patients who may benefit from vv-ECMO.© 2022. The Author(s).

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