• Odd Jarle Kjørstad and Dagny Faksvåg Haugen.
• Department of Oncology, Førde Central Hospital, Førde, Norway. odd.jarle.kjoerstad@helse-forde.no
• Tidsskr. Nor. Laegeforen. 2013 Feb 19; 133 (4): 417-21.

BackgroundThe criteria for refraining from cardiopulmonary resuscitation in palliative care cancer patients are based on patients' right to refuse treatment and the duty of the treating personnel not to exacerbate their suffering and not to administer futile treatment. When is cardiopulmonary resuscitation futile in these patients?MethodSystematic literature searches were conducted in PubMed for the period 1989-2010 on the results of in-hospital cardiopulmonary resuscitation in advanced cancer patients and on factors that affected the results of CPR when special mention was made of cancer. The searches yielded 333 hits and 18 included articles: four meta-analyses, eight retrospective clinical studies, and six review articles.ResultsCancer patients had a poorer post-CPR survival than non-cancer patients. Survival declined with increasing extent of the cancer disease. Widespread and therapy-resistant cancer disease coupled with a performance status lower than WHO 2 or a PAM score (Pre-Arrest Morbidity Index) of above 8 was regarded as inconsistent with survival after cardiopulmonary resuscitation.InterpretationCardiopulmonary resuscitation is futile for in-hospital cancer patients with widespread incurable disease and poor performance status.

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