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Prognostic factors for malignant pericardial effusion treated by pericardial drainage in solid-malignancy patients

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Abstract

Purpose

Malignant pericardial effusion is a frequent complication of advanced incurable malignancies and requires treatment. The purpose of this study was to identify prognostic factors for cytology-positive malignant pericardial effusion in patients treated by pericardial drainage.

Methods

We retrospectively analyzed a series of consecutive patients diagnosed with cytologically positive malignant pericardial effusion who were treated by pericardial drainage at the National Cancer Center Hospital, Tokyo.

Results

A total of 88 patients with pericardial effusion were treated by pericardial drainage, 60 patients were diagnosed with cytological positive malignant pericardial effusion including 32 with non-small cell lung cancer, 13 with breast cancer, 8 with gastrointestinal cancer, and 7 with miscellaneous cancers. Subxiphoid pericardiostomy was performed in 50 of the patients and percutaneous tube pericardiostomy in the other 10 patients. Malignant pericardial effusion recurred in 14 patients, and pericardial drainage was performed again in 9 of them. The median overall survival time was 6.1 months, and the 1-year survival rate was 28%. A multivariate analysis revealed the following significant negative prognostic factors: performance status, development of malignant pericardial effusion during chemotherapy, mediastinal lymph node enlargement, and cytologic type. (P = 0.03, 0.02, 0.01, 0.001, respectively).

Conclusion

Patients with poor prognostic factors may be better to consider as indication of palliative therapy, even if oncologic emergency had been resolved rapidly by drainage.

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Acknowledgement

Authors thank to Hajime Uno, (Division of Biostatistics, Kitasato University Graduate School), Shunichi Watanabe, Kenji Suzuki (Division of Thoracic Surgery, National Cancer Center Hospital), Tsutomu Kouno, Hiroshi Nokihara, Ikuo Sekine, Yuichiro Ohe (Division of Medical Oncology, National Cancer Center Hospital), and Yoshihiro Matsuno (Division of Clinical Laboratory, National Cancer Hospital) for their assistance.

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Authors and Affiliations

  1. Division of Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Kan Yonemori, Hideo Kunitoh, Yasuhiro Fujiwara & Tomohide Tamura

  2. Division of Clinical laboratory, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Koji Tsuta & Yuko Sasajima

  3. Division of Cardiology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Tetsutaro Tamura

  4. Division of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Yasuaki Arai

  5. Division of Thoracic Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Hisao Asamura

  6. Division of Gastrointesinal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Yasuhiro Shimada

Authors
  1. Kan Yonemori
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  2. Hideo Kunitoh
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  3. Koji Tsuta
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  7. Yasuhiro Fujiwara
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  8. Yuko Sasajima
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  9. Hisao Asamura
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  10. Tomohide Tamura
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Correspondence to Kan Yonemori.

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Yonemori, K., Kunitoh, H., Tsuta, K. et al. Prognostic factors for malignant pericardial effusion treated by pericardial drainage in solid-malignancy patients. Med Oncol 24, 425–430 (2007). https://doi.org/10.1007/s12032-007-0033-9

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  • DOI: https://doi.org/10.1007/s12032-007-0033-9

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