{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:01:01Z","timestamp":1792789261925,"version":"4.5.0"},"reference-count":73,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Romanian National Society of Medical Oncology"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: The intersection between oncology and intensive care has shifted from predominantly end-of-life care to a therapeutic bridge that can preserve anticancer trajectories in carefully selected patients. Yet, criteria separating benefit from futility remain fragmented. Objective: This paper seeks to map contemporary evidence (2015\u20132025) on outcomes after Intensive Care Unit (ICU) admission in adults with cancer and to identify clinical constellations in which ICU-level care still changes prognosis. Methods: PRISMA-ScR scoping review (PCC framework). PubMed search (2015\u20132025), dual screening, standardized extraction; narrative\/thematic synthesis across six clusters (hematologic, solid tumors, sepsis\/non-COVID-19 infection, COVID-19\/viral pneumonia, novel\/targeted-therapy toxicities, end-of-life\/aggressive ICU) were used. No meta-analysis given heterogeneity. Results: Seventy-three studies (&gt;170,000 ICU admissions) were included, mostly cohort designs across 27 countries. ICU mortality ranged 8\u201372% (weighted mean \u2248 41%); hospital \u2248 38%; 90-day \u2248 46%; 1-year \u2248 62%. About one third of ICU survivors resumed systemic therapy. Benefit concentrated in early admissions, single-organ failure, controlled\/remission disease, postoperative\/elective monitoring, and reversible treatment-related toxicities (e.g., ICI pneumonitis, CAR-T CRS\/ICANS). Futility clustered around \u22653 organ supports, RRT &gt; 7 days, refractory\/progressive disease, and ECOG \u2265 3. Sepsis outcomes averaged 45\u201355% ICU mortality but improved with rapid recognition and source control; COVID-19 mortality was particularly high in hematologic malignancies early in the pandemic, with subsequent declines post-vaccination. Conclusions: In modern oncologic practice, ICU care changes prognosis when the acute physiological insult is reversible and cancer control remains plausible; conversely, high organ-support burden and refractory disease define practical futility thresholds. These signals support time-limited ICU trials, earlier ICU involvement for sepsis\/irAEs, and embedded palliative care to align intensity with goals.<\/jats:p>","DOI":"10.3390\/cancers17223636","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T09:59:09Z","timestamp":1763027949000},"page":"3636","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["When and for Whom Does Intensive Care Unit Admission Change the Prognosis in Oncology?\u2014A Scoping Review"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2381-5577","authenticated-orcid":false,"given":"Ioana Roxana","family":"Codru","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania"},{"name":"Anesthesia and Intensive Care Department, Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5020-8825","authenticated-orcid":false,"given":"Liliana","family":"Vecerzan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania"},{"name":"Oncology Department, Clinical Military Emergency Hospital of Sibiu, 550024 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/S2213-2600(18)30345-X","article-title":"Acute respiratory failure in immunocompromised adults","volume":"7","author":"Azoulay","year":"2019","journal-title":"Lancet Respir. 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