Systemic chemotherapy in combination with pericardial window has better outcomes in malignant pericardial effusions

Çelık, Seden; Lestuzzi, Chiara; Cervesato, Eugenio; Dequanter, Didier; Piotti, Patrizia; Biasio, Marzia De; Imazio, Massimo

doi:10.1016/j.jtcvs.2014.04.031

Cited by 41 publications

(36 citation statements)

References 17 publications

(23 reference statements)

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“…Several studies have suggested that the surgical method provides more definitive primary treatment of malignant PE compared to pericardiocentesis (6–8); however, this approach is associated with significant morbidity (4,9–12). As instruments and techniques have improved – especially the use of echography guidance for percutaneous and catheter-based procedures – clinical application of minimally invasive techniques has often outpaced the published data regarding their safety and efficacy.…”

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confidence: 99%

Outcomes of Cancer Patients Undergoing Percutaneous Pericardiocentesis for Pericardial Effusion

Haddad

Iliescu

Yusuf

et al. 2015

Journal of the American College of Cardiology

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BACKGROUND Pericardial effusion (PE) is common in cancer patients but the optimal therapeutic approach is not well defined. Percutaneous pericardiocentesis is less invasive than surgery, but its long-term effectiveness and safety are not well documented. OBJECTIVES We evaluated outcomes of cancer patients undergoing percutaneous pericardiocentesis for PE and assessed the procedure’s safety in patients with thrombocytopenia. METHODS Cancer patients who underwent percutaneous pericardiocentesis for PE between November 2009 and October 2014 at MD Anderson Cancer Center were included. Procedure-related complications, effusion recurrence rate, and overall survival were analyzed. RESULTS Of 1,645 cancer patients referred for PE, 212 (13%) underwent percutaneous pericardiocentesis. The procedure was successful in 99% of the cases with no procedure-related deaths. Four patients had major procedure-related bleeding that did not vary by platelet count <50,000/µl or ≥50,000/µl (p = 0.1281). Patients with catheter drainage for 3 to 5 days had the lowest recurrence rate (10%). Median overall survival was 143 days with age >65 years, lung cancer, platelet count <20,000/µl, and malignant pericardial fluid independently associated with poor prognosis. Lung cancer patients with proven malignant effusions had a significantly shorter median 1-year survival compared to those with nonmalignant effusions (16.2% vs. 49.0%, respectively; log-rank test p value = 0.0101). A similar difference in 1-year survival was not observed in breast cancer patients (40.2% vs. 40.0%, respectively; log-rank test p = 0.4170). CONCLUSION Percutaneous pericardiocentesis with extended catheter drainage, as primary treatment for PE in cancer patients, is safe and effective, including in those with thrombocytopenia. Malignant PE significantly shortens the survival outcome of lung, but not breast, cancer patients.

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confidence: 99%

Outcomes of Cancer Patients Undergoing Percutaneous Pericardiocentesis for Pericardial Effusion

Haddad

Iliescu

Yusuf

et al. 2015

Journal of the American College of Cardiology

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“…Some patients with neoplastic PT might require a surgical procedure, such as a pericardial window, for long-term symptomatic relief [19]. A prospective study by Celik et al [20] showed that systemic chemotherapy plus pericardial window was more effective than either chemotherapy alone or chemotherapy plus pericardial drain placement in patients with malignant effusions. Considering the nonmalignant causes of pericardial effusion in malignancy culture, cell count, and cytology of the pericardial fluid would be necessary.…”

Section: Pericardial Disease: Pericardial Constriction and Pericardiamentioning

confidence: 99%

Cardiovascular Oncologic Emergencies

et al. 2017

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Oncologic emergencies can present either as a progression of a known cancer or as the initial presentation of a previously undiagnosed cancer. In most of these situations, a very high degree of suspicion is required to allow prompt assessment, diagnosis, and treatment. In this article, we review the presentation and management of cardiovascular oncologic emergencies from primary and metastatic tumors of the heart and complications such as pericardial tamponade, superior vena cava syndrome, and hyperviscosity syndrome. We have included the cardiovascular complications from radiation therapy, chemotherapeutic agents, and biologic agents used in modern cancer treatment.

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“…No obstante, se ha encontrado disminución de la recurrencia del derrame pericárdico (15 %) y mayor supervivencia global a los siete meses, en los pacientes sometidos a ventana pericárdica por toracotomía antero-lateral izquierda, frente a 31 % de recurrencia y supervivencia a solo tres meses en el grupo con drenaje percutáneo guiado por imágenes 25 . En una serie de 1.841 pericardiocentesis, se encontró que la supervivencia del paciente se relacionaba con el tipo histológico del tumor primario y la posibilidad de tratamiento sistémico, con supervivencia mayor de tres meses para el cáncer de mama del 93 % y del 72 % 9 .…”

Section: Principios Del Tratamiento Del Derrame Pericárdico En Pacienunclassified

Manejo del derrame pericárdico en el paciente con cáncer

et al. 2017

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Systemic chemotherapy in combination with pericardial window has better outcomes in malignant pericardial effusions

Abstract: Systemic CT plus pericardial window is a more effective treatment option compared with systemic CT alone and systemic CT plus drainage in patients with malignant effusions.

Cited by 41 publications

References 17 publications

Outcomes of Cancer Patients Undergoing Percutaneous Pericardiocentesis for Pericardial Effusion

Outcomes of Cancer Patients Undergoing Percutaneous Pericardiocentesis for Pericardial Effusion

Cardiovascular Oncologic Emergencies

Manejo del derrame pericárdico en el paciente con cáncer

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