Survival After Surgical Drainage of Malignant Pericardial Effusion

Objectives Management of malignant pericardial effusion (PE) is complex. Cardiac surgeons are not necessarily familiar with or are challenged by the many underlying etiologies. Analyzing risk factors for mortality may help to estimate the benefit of surgery in high-risk patients. Methods Patients un...

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Bibliographic Details
Published in:World journal of surgery 2015-07, Vol.39 (7), p.1767-1772
Main Authors: Niclauss, Lars, Montemurro, Michael, Prêtre, René
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adult
Aged
Breast Neoplasms - complications
Breast Neoplasms - surgery
Cardiac Surgery
Digestive System Neoplasms - complications
Digestive System Neoplasms - surgery
Drainage
Dyspneic Patient
Female
General Surgery
Hospital Mortality
Humans
Kaplan-Meier Estimate
Leukemia - complications
Leukemia - surgery
Lung Neoplasms - complications
Lung Neoplasms - surgery
Lymphoma - complications
Lymphoma - surgery
Male
Malignant Pericardial Effusion
Medicine
Medicine & Public Health
Middle Aged
Neoplasms - complications
Neoplasms - mortality
Original Scientific Report
Pericardial Drainage
Pericardial Effusion
Pericardial Effusion - etiology
Pericardial Effusion - surgery
Pericardiectomy
Prognosis
Recurrence
Surgery
Thoracic Surgery
Vascular Surgery
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Summary:Objectives Management of malignant pericardial effusion (PE) is complex. Cardiac surgeons are not necessarily familiar with or are challenged by the many underlying etiologies. Analyzing risk factors for mortality may help to estimate the benefit of surgery in high-risk patients. Methods Patients undergoing a surgical pericardiotomy for malignant PE, between 2001 and 2011, were included. The influence of tumor type, disease extension, intra-pericardial tumor infiltration on early mortality and long-term survival as well as freedom from symptoms after drainage, and the use of sclerosing agents on PE recurrence rates was analyzed. Results PE drainage was performed on 46 patients 12 ± 30 months after tumor diagnosis. Malignant diseases were lung cancers (50 %), breast cancers (15 %), lymphoma and leukemia (13 %), cancers of the digestive tract (13 %), and others (9 %). 80 % of patients were symptomatic and symptom relief was achieved in 65 %. Nobody died during surgery. Recurrence rate was 4 %. Early in-hospital mortality was 22 %. After 1 year, 29 % of patients were alive. Eleven patients (24 %) had a complete tumor regression. Metastatic spread ( p  
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-015-3025-5