The present and the future of oncocardiology team in current multi-field surgical clinic

Belov, Yu. V.; Kim, E. F.; Charchyan, E. R.; Bedzhanyan, A L; Shestakov, A. L.; Evseev, E. P.; Еременко, А. А.; Nikoda, V V; Дымова, О. В.; Frolova, Yu V

doi:10.17116/kardio2019120115

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“…Неологизм «кардиоонкология» впервые был введен в литературу в 1996 г. D. Cardinale для описания новой области интегративной медицины, подразумевающей тесное сотрудниче-ство между кардиологами и онкологами [6][7][8][9][10]. В частности, к задачам кардиоонкологии относятся оценка рисков и профилактика сердечнососудистых осложнений при проведении онкологических операций [3,11].…”

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Surgical treatment of cancer in the elderly with concomitant cardiovascular pathology

Bedzhanyan¹,

Bagmet²,

Nikoda³

et al. 2020

Clinical and Experimental Surgery. Petrovsky journal

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Background. The leading causes of mortality in the elderly population around the world remain cardiovascular diseases, malignant tumors of the abdominal cavity and pelvic organs, requiring extensive reconstructive surgery. Aim -to assess the safety of surgical interventions in elderly cancer patients with concomitant cardiovascular pathology. Material and methods. 52 patients under the age of 65 (28 men and 24 women) underwent various types of surgical treatment for colorectal cancer, stomach cancer, esophageal cancer, hepatocellular cancer, colorectal liver metastases, pancreatic cancer, bile duct cancer, uterine and ovarian cancer, kidney cancer, prostate cancer. Results. Preoperative correction of cardiac therapy was required in 16 (30.8%) patients. The clinical status of patients was assessed according to the classification to New York Hear Association (NYHA) of chronic heart failure: 13 patients were classified as functional class (FC) I, 16 as FC II, 2 as FC III, other patients (n=21) did not have clinical signs of heart failure (0 FC). Preoperative risks of developing cardiovascular complications in the 30-day postoperative period were evaluated with the Revised Cardiac Risk Index (RCRI). Clavien grade III-V surgical complications developed in 11.5% of cases; the frequency of significant complications from the cardiovascular system was 3.8% with a calculated value on the RCRI scale of ~9%. According to the analysis of risk factors of postoperative complications, they correlated with duration of ICU stay, with a significant lengthening of hospital stay and depended on the severity of heart failure, assessed according to NYHA classification (p=0.0004). Conclusion.Our experience demonstrated that the reason of the successful treatment of these patients is the implementation of the personalized approach of the cardio-oncological team. Determination of functional reserves and the risks of cardiovascular complications and their prevention play an important role in the planning of the combined treatment for oncological patient of elderly and senile age. Funding. The study had no sponsor support. Conflict of interests. The authors declare no conflict of interests. Contribution of authors. Contribution. Writing a work, scientific and practical guidance, statistical analysis of the obtained clinical and instrumental data -Bedzhanyan A.L.; participation in the surgical treatment of patients with oncology of the abdominal cavity organs -Bagmet N.N.; participation in resuscitation treatment -Nikoda V.V.; participation in the anesthetic aid -Zaytsev A.Yu., clinical management of patients -Sysoev S.Yu.; collection and presentation of laboratory data -Dymova O.V.; participation in the surgical treatment of patients with gyneco-oncology -Tyan A.G.; participation in cardiological examination and treatment of patients -Frolova Yu.V.

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