Cardiopulmonary resuscitation in cancer patients: still some problems to solve

We reply to Vincent et al. who made valuable comments on our recently published review concerning do-not-resuscitate orders in cancer patients in this journal. We emphasize the difficulties in estimating the prognosis in cancer patients after cardiopulmonary resuscitation and discuss the mentioned study by Champigneulle et al., which results might by influenced by selection bias. Performance scores seem to be an important prognostic factor. However, there is lack of studies determining the exact value in cancer patients after cardiopulmonary resuscitation. We believe interprofessional consultation and discussion should always precede do-not-resuscitate orders. Interviews with oncologists and general practitioners show that there is room for improvement on this matter. More advance directives are written over the last years. However, studies show that patients more often want to discuss the matter than that it is addressed by their physicians.