Poor Outcome and Prolonged Hospital Stay after the Diagnosis of Liver Abscesses in Hospitalized Cancer Patients: A Single Center Experience

Background: Liver abscesses are uncommon, but they are associated with a hospital mortality rate of 10% in patients without cancer. However, its relevance in cancer patients in terms of survival and length of hospitalization is unknown. Patients and Methods: We conducted an observational study in order to analyze the impact of liver abscesses in hospitalized cancer patients. Eligible patients were adults with a solid tumor, received antineoplastic treatment and were hospitalized in our department with a diagnosis of liver abscesses. Primary end-points of the study were overall survival (OS) and mean hospital stay (MHS). Secondary end-points were the description of risk factors of liver abscesses, isolated microorganisms and the specific treatment. Results: In our study the incidence of liver abscesses in cancer patients was 1.85%. Median age was 64 years, 60% were men, and the vast majority of patients had an advanced bilio-pancreatic tumor (80%). With a median follow-up of 18 months, median OS was 6 months (95% CI: 1-12); and OS probability at 18-month was 27%. MHS was 30.5 days (95% CI: 20.3-40.7). Risk factors for developing liver abscesses were: a) bilio-pancreatic cancers; b) chemotherapy administration; c) severe malnutrition; and d) biliary drainage/prosthesis. Eight patients (53.3%) had bacteremia, and the most common isolated microorganism was E.coli (33.3%). Percutaneous drainage of abscesses was performed in 53.3% of the patients, and all patients were treated with broad-spectrum antibiotics. Conclusion: Although liver abscesses were uncommon, they were associated with a prolonged hospitalization and poor outcome in cancer patients.