The cardiopulmonary bypass and cancer dissemination puzzle

Évora, Paulo Roberto Barbosa; Albuquerque, Agnes Afrodite Sumarelli; Nadai, Tales Rubens de; Mente, Ênio David; Sankarankuty, Ajith; Castro‐e‐Silva, Orlando

doi:10.1590/s0102-865020180110000010

Cited by 3 publications

(2 citation statements)

References 9 publications

(8 reference statements)

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“…Finally, further research is needed to know whether the transient immunosuppression associated with CPB can promote the spread and growth of pre-existing cancer cells. However, adverse effects of CPB on cancer prognosis are expected but have not been confirmed [11,12] .…”

Section: Discussionmentioning

confidence: 99%

Right Atrium Tumor Extension Through the Inferior Vena Cava. Considerations About Nine Cases Operated Under Cardiopulmonary Bypass

Chaud¹,

Tucci²,

Bassetto³

et al. 2019

Braz J Cardiovasc Surg

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IntroductionAdrenocortical and renal cell carcinomas rarely invade the right atrium (RA). These neoplasms need surgical treatment, are very aggressive and have poor prognostic and surgical outcomes.Case seriesWe present a retrospective cohort of nine cases of RA invasion through the inferior vena cava (four adrenocortical carcinomas and five renal cell carcinomas). Over 13 years (2002-2014), nine patients were operated in collaboration with the team of urologists. Surgery was possible in all patients with different degrees of technical difficulty. All patients were operated considering the imaging examinations with the aid of CPB. In all reported cases (renal or suprarenal), the decision to use CPB with deep hypothermic circulatory arrest (DHCA) on surgical strategy was decided by the team of urological and cardiac surgeons.ConclusionData retrospectively collected from patients of public hospitals reaffirm: 1) Low incidence with small published series; 2) The selected cases did not represent the whole historical casuistry of the hospital, since they were selected after the adoption of electronic documentation; 3) Demographic data and references reported in the literature were presented as tables to avoid wordiness; 4) The series highlights the propensity to invade the venous system; 5) Possible surgical treatment with the aid of CPB in collaboration with the urology team; 6) CPB with DHCA is a safe and reliable option; 7) Poor prognosis with disappointing late results, even considering the adverse effects of CPB on cancer prognosis are expected but not confirmed.

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Section: Discussionmentioning

confidence: 99%

Right Atrium Tumor Extension Through the Inferior Vena Cava. Considerations About Nine Cases Operated Under Cardiopulmonary Bypass

Chaud¹,

Tucci²,

Bassetto³

et al. 2019

Braz J Cardiovasc Surg

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“…CPB is known to lead not only to a systemic inflammatory state but also to an immunosuppression one (10)(11)(12). So, theoretically, this could allow cancer to spread and recur (13). This relation is still unclear despite the advances in cardiac and oncologic treatments and the increase in publications about these themes.…”

Section: Review Articlementioning

confidence: 99%

Cardiopulmonary bypass and cancer dissemination and progression: myth reality, enigma, puzzle?

Li¹,

Wada²,

Évora³

2023

Curr Chall Thorac Surg

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Cardiac disease (CD) and oncologic disease (OD) are among the most lethal diseases. Both share common risk factors and as a consequence, there are a substantial number of patients who need surgeries for problems related to both diseases. Treatments for OD should start as soon as possible, as the disease can progress and disseminate, reducing life expectancy for patients. At times, heart problems may need cardiac surgery (CS), which are sophisticated and peculiar, at many times needing a machine to do the lung and the heart function as the surgeon does his job. This is called cardiopulmonary bypass (CPB), a procedure that is known to be related to inflammation and immunosuppression syndromes, that could lead the cancer disease to disseminate. There is little information on this subject in the literature so, in this narrative review, we have made a literature review, trying to address whether this theoretical worry confirms at evidencebased medicine. We also described some considerations regarding the use of devices like Cell Saver ® and autotransfusion in oncologic patients. Further, we have taken some considerations about what care should be taken when facing situations with patients of different stages of OD needing CS and what should be discussed multidisciplinary aiming a treatment that best fits patient's life-expectancy and clinical status.

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Complete Resection of a Cavoatrial Metastatic Liposarcoma under Hypothermic Circulatory Arrest

Matsumoto

Fujiyoshi

Kamiya

et al. 2023

ATCS

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The cardiopulmonary bypass and cancer dissemination puzzle

Cited by 3 publications

References 9 publications

Right Atrium Tumor Extension Through the Inferior Vena Cava. Considerations About Nine Cases Operated Under Cardiopulmonary Bypass

Right Atrium Tumor Extension Through the Inferior Vena Cava. Considerations About Nine Cases Operated Under Cardiopulmonary Bypass

Cardiopulmonary bypass and cancer dissemination and progression: myth reality, enigma, puzzle?

Complete Resection of a Cavoatrial Metastatic Liposarcoma under Hypothermic Circulatory Arrest

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