Superior vena cava syndrome in non-lung primary tumours treated with palliative intent

This study aimed to evaluate the effects of systemic treatment on the overall survival (OS) of patients with superior vena cava (SVC) syndrome caused by neoplasms other than lung and haematological cancers.

Patient data were collected retrospectively. Cox proportional hazards regression was used to analyse the associations between variables and time to death.

Twenty-four patients were identified. The median follow-up time was 36 months. The median OS of patients receiving upfront systemic treatment and radiotherapy were 252 and 150 days (p = 0.298), and the 1-year OS rates were 20% and 22.7%, respectively. Patients treated with and without steroids had 1-year OS rates of 30.8% and 10.1% and median OS of 154 and 224 days, respectively (p = 0.426). The median OS of patients treated with and without loop diuretics was 114 and 252 days (p = 0.004), and the 1-year OS rates were 0% and 33.6%, respectively. In multivariable analysis, significant independent factors included upfront systemic therapy [hazard ratio (HR) = 0.022; 95% confidence interval (CI): 0.001-0.413], loop diuretics (HR = 12.364; 95% CI: 2.093-73.032), male sex (HR = 9.746; 95% CI: 1.478-64.276), visceral metastases (HR = 96.265; 95% CI: 5.437-1704.39), and previous systemic treatment for nonmetastatic disease (HR = 0.072; 95% CI: 0.005-0.955).

In multivariable analysis, systemic treatment was associated with improved survival. However, this finding remains exploratory because of the small sample size and model instability. Loop diuretics were associated with increased mortality, and steroids showed no benefit in improving survival.