Overall survival and association factors of malignant superior vena cava syndrome in Suratthani Hospital

Abstract

Background: Superior vena cava (SVC) syndrome is an oncologic emergency associated with high mortality. Treatment outcomes depend on multiple clinical and therapeutic factors.

Objective: To study survival rates and associated prognostic factors in cancer patients with malignant SVC syndrome.

Methods: This retrospective study included cancer patients diagnosed with malignant SVC syndrome confirmed by histopathology at Surat Thani Hospital between 2017 and 2024. Survival analysis was performed using the Kaplan–Meier method. Differences between groups were assessed with the log-rank test, and multivariable prognostic factors were analyzed using the Cox proportional hazards regression model.

Result:   A total of 215 patients were included, with a mean age of 52 years (SD 16.3); 76.7% were male. Lung cancer was the most common cause (65%), followed by lymphoma (16.3%). Chemotherapy and radiotherapy were administered in 62.7% and 44.2% of cases, respectively. The overall survival rates at 1, 2, and 5 years were 33.75% (95%CI 27.2–40.41), 22.21% (95%CI 16.4–28.6), and 14.48% (95%CI 8.85–21.45), respectively. The median overall survival was 6.4 months (IQR 3.8–7.36). Multivariable analysis identified Eastern Cooperative Oncology Group (ECOG) performance status 4 as an adverse prognostic factor (adjusted hazard ratio [aHR] 3.63; 95% CI 1.73–7.64; p=0.001), while receipt of chemotherapy was associated with improved survival (aHR 0.45; 95% CI 0.30–0.67; p<0.001).

Conclusion: Association factors for survival in malignant SVC syndrome were ECOG performance status 4, which was associated with poorer outcomes, and receipt of chemotherapy, which was associated with better survival.