Objectives/purpose:
Inpatient systemic therapy is often reserved for patients with complex clinical needs and aggressive malignancies. However, there is a lack of standardized guidelines to define appropriate indications for inpatient systemic therapy. This study aims to evaluate clinical outcomes of patients who received inpatient systemic therapy, focusing on patient selection tendencies, rehospitalization rates and survival outcomes.
Sample and setting:
Patients with solid-organ malignancies who received inpatient systemic therapy at Sir Charles Gairdner Hospital over the period of January – May 2024 were included in this study. Data collection occurred in the period of April – May 2025.
Procedures:
Patient and treatment variables including cancer type, systemic therapy regimen and indications for inpatient treatment were collected through chart reviews. Clinical outcomes including length of hospital stay, 30-day readmission rates and survival data were collected and analysed.
Results:
A total of 52 patients received systemic therapy over the study period. The median age was 62 years (range 17-84). These patients represented 13 different tumour groups, the most prevalent tumours being upper gastrointestinal (17.3%), small cell lung cancer (13.5%), sarcoma and gynaecological (11.5% each). Most patients (84.6%) received systemic therapy for indications with immediate clinical need. The median length of hospital stay was 10 days (range 1 – 59). 27 patients (48.1%) experienced rehospitalization within 30 days of their systemic therapy treatment, including 8 patients (15.4%) with treatment-related toxicity and 2 patients (3.8%) admitted with disease progression. The median survival using Kaplan-Meier analysis was 38 weeks.
Conclusion:
Our study has demonstrated variability in patient selection for inpatient systemic therapy, along with high rehospitalization rates and poor survival outcomes. This underscores the potential need for up-to-date standardized consensus guidelines to support consistent clinical decision-making.
Key words: Systemic therapy, Cancer, Inpatient