Cardiac metastasis after esophagogastrectomy for esophageal adenocarcinoma with an antemortem diagnosis

Yagawa, Yohsuke; Narumiya, Kosuke; Kudo, Kenji; Maeda, Shinsuke; Toyoshima, Yukinori; Ogawa, Kyohei; Tanigawa, Keishi; Hashimoto, Y.; Nagashima, Yoji; Osugi, Harushi; Egawa, Hiroto

doi:10.1007/s12328-021-01557-6

Cited by 2 publications

(3 citation statements)

References 33 publications

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“…According to the eighth edition Staging of Esophageal and Esophagogastric Epithelial Cancers (35), pericardial invasion is defined as stage T4a, which suggests a relatively poor prognosis. Cardiac invasion of esophageal tumors is rare but lethal (36,37). In our study, we found that the cardiac compression by esophageal tumor was negatively correlated with the survival time of patients, although cardiac compression was not statistically associated with severe cardiac events.…”

Section: Discussionmentioning

confidence: 50%

Predictive effect of J waves on cardiac compression and clinical prognosis of esophageal tumors: a retrospective study

Shen

Xie

et al. 2022

J Gastrointest Oncol

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Background: The J wave syndromes (JWS) could be observed in patients with mediastinal tumors, though few studies have verified the statistical correlation between J waves and cardiac compression by tumors. This study aimed to investigate the relationship between J waves and cardiac compression by esophageal tumor and to compare the prediction of J waves on clinical prognosis with that of cardiac compression by esophageal tumor. Methods:We enrolled 273 patients (228 males, 45 females; mean 63.8±7.5 years) with esophageal tumors admitted to Shanghai Chest Hospital between August 2016 and November 2020. The J wave was defined as a J-point elevation of ≥0.1 mV in a 12-lead electrocardiogram (ECG) and classified into multiple types.Chest computed tomography (CT) was reviewed to clarify the anatomical relationship between the heart and the esophageal tumor. The prognosis of severe cardiac events and survival status were followed up through medical history, examination records and telephone records.Results: J waves were present in 141 patients among all 273 cases. The sensitivity and specificity of cardiac compression by the tumor for J waves were 78.1% and 67.3%, respectively. The odds ratio (OR) of cardiac compression by the tumor to J waves was 7.33 [95% confidence interval (CI): 4.21-12.74; P<0.001]. The Kappa coefficient between J waves and cardiac compression was 0.44±0.05. The significance association between J waves and cardiac compression was independent from other clinical variables (P<0.001). Decreased J wave amplitude was correlated with the disappearance of cardiac compression during follow-up (P=0.03).Patients with J waves had a higher risk of severe cardiac events than those without J waves (OR =2.84, 95% CI: 1.22-6.63; P=0.01). During the follow-up period, we found that the presence of J waves [hazard ratio (HR) =2.28; 95% CI: 1.35-3.84; P=0.002] and cardiac compression by the tumor (HR =2.51; 95% CI: 1.51-4.17; P<0.001) were both negatively correlated with the survival time of patients. Conclusions:The presence of J waves could be used as an effective mean to predict the mechanical impact of esophageal tumor on the heart, and played an important role in predicting the survival of patients.

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Section: Discussionmentioning

confidence: 50%

Predictive effect of J waves on cardiac compression and clinical prognosis of esophageal tumors: a retrospective study

Shen

Xie

et al. 2022

J Gastrointest Oncol

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“…Cardiac tamponade can be seen with the pericardial invasion of the tumour, with heart failure in cases of extended infiltration. Symptoms tend to appear once the tumor reaches 4 cm in diameter [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…The patient was initially treated with a single 8 Gy fraction of urgent hemostatic radiotherapy, and began palliative chemotherapy, bearing in mind the need for diligent monitoring given the risk of cardiac vasospasm from capecitabine and his recent cardiac surgery [ 9 , 12 ]. Another fraction of hemostatic radiotherapy was needed after he began anticoagulation for a pulmonary embolus, highlighting a common challenge for patients with in-situ upper abdominal primary cancers.…”

Section: Discussionmentioning

confidence: 99%

A Case Report of an Isolated Cardiac Metastasis in a Patient with Esophageal Carcinoma

Aziz,

Hsu,

Toeg

et al. 2023

Cureus

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A 76-year-old Caucasian male presented with syncope, intermittent melena, anemia, and unexplained weight loss. Esophagogastroduodenoscopy revealed a friable non-obstructing esophageal tumor that appeared thickened on computed tomography (CT). Biopsies confirmed a poorly differentiated carcinoma. Fluorine-18 fluorodeoxyglucose positron emission tomography/CT (F-18 FDG PET/CT) showed intense FDG avidity with a maximum standardized uptake value (SUV max ) of 23. Although CT did not identify any lymphadenopathy or distant metastases, a mildly enhancing lobulated circumscribed mass with no internal calcification was incidentally identified in the left atrium. Cardiac magnetic resonance imaging (MRI) favored myxoma over thrombus given the signal characteristics and mild enhancement; however, F-18 FDG PET/CT showed an SUV max of 18, more consistent with a metastasis. The cardiac mass was resected and shown to be a metastatic focus of poorly differentiated carcinoma, histologically identical to the esophageal mass. He received a single 8 Gray (Gy) fraction of urgent hemostatic radiotherapy for his primary tumor followed by palliative chemotherapy with cisplatin, capecitabine, and pembrolizumab. He was readmitted for transfusion due to recurrent bleeding from his primary tumor and given a second urgent hemostatic fraction of 8 Gy for stabilization. Systemic therapy was eventually discontinued due to declining performance status. He received consolidative palliative radiotherapy (20Gy in five fractions) but continued to deteriorate over the next three months and died in hospice, ten months from the time of his initial presentation.

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Cardiac metastasis after esophagogastrectomy for esophageal adenocarcinoma with an antemortem diagnosis

Cited by 2 publications

References 33 publications

Predictive effect of J waves on cardiac compression and clinical prognosis of esophageal tumors: a retrospective study

Predictive effect of J waves on cardiac compression and clinical prognosis of esophageal tumors: a retrospective study

A Case Report of an Isolated Cardiac Metastasis in a Patient with Esophageal Carcinoma

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