Danielle El Haddad1, Cezar Iliescu1, Syed Wamique Yusuf1, William Nassib William2, Tarif H Khair3, Juhee Song4, Elie N Mouhayar5. 1. Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 2. Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 3. Department of Cardiology, The University of Texas Medical School at Houston, Houston, Texas. 4. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas. 5. Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: emouhayar@mdanderson.org.
Abstract
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 have not been well documented. OBJECTIVES: The goal of this study was to evaluate outcomes of cancer patients undergoing percutaneous pericardiocentesis for PE and assess the procedure's safety in patients with thrombocytopenia. METHODS: Cancer patients who underwent percutaneous pericardiocentesis for PE between November 2009 and October 2014 at the 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, and there were 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; older age (i.e., >65 years), lung cancer, platelet count <20,000/μl, and malignant pericardial fluid were independently associated with poor prognosis. Lung cancer patients with proven malignant effusions had a significantly shorter median 1-year survival compared with those with nonmalignant effusions (16.2% vs. 49.0%, respectively; log-rank test p = 0.0101). A similar difference in 1-year survival was not observed in patients with breast cancer (40.2% vs. 40.0%; log-rank test p = 0.4170). CONCLUSIONS: Percutaneous pericardiocentesis with extended catheter drainage was safe and effective as the primary treatment for PE in cancer patients, including in those with thrombocytopenia. Malignant PE significantly shortened the survival outcome of patients with lung cancer but not those with breast cancer.
BACKGROUND:Pericardial effusion (PE) is common in cancerpatients, but the optimal therapeutic approach is not well defined. Percutaneous pericardiocentesis is less invasive than surgery, but its long-term effectiveness and safety have not been well documented. OBJECTIVES: The goal of this study was to evaluate outcomes of cancerpatients undergoing percutaneous pericardiocentesis for PE and assess the procedure's safety in patients with thrombocytopenia. METHODS:Cancerpatients who underwent percutaneous pericardiocentesis for PE between November 2009 and October 2014 at the MD Anderson Cancer Center were included. Procedure-related complications, effusion recurrence rate, and overall survival were analyzed. RESULTS: Of 1,645 cancerpatients referred for PE, 212 (13%) underwent percutaneous pericardiocentesis. The procedure was successful in 99% of the cases, and there were 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; older age (i.e., >65 years), lung cancer, platelet count <20,000/μl, and malignant pericardial fluid were independently associated with poor prognosis. Lung cancerpatients with proven malignant effusions had a significantly shorter median 1-year survival compared with those with nonmalignant effusions (16.2% vs. 49.0%, respectively; log-rank test p = 0.0101). A similar difference in 1-year survival was not observed in patients with breast cancer (40.2% vs. 40.0%; log-rank test p = 0.4170). CONCLUSIONS: Percutaneous pericardiocentesis with extended catheter drainage was safe and effective as the primary treatment for PE in cancerpatients, including in those with thrombocytopenia. Malignant PE significantly shortened the survival outcome of patients with lung cancer but not those with breast cancer.
Authors: Ambuj Kumar; Rahul Mhaskar; Brenda J Grossman; Richard M Kaufman; Aaron A R Tobian; Steven Kleinman; Terry Gernsheimer; Alan T Tinmouth; Benjamin Djulbegovic Journal: Transfusion Date: 2014-11-12 Impact factor: 3.157
Authors: Nimish Patel; Asim M Rafique; Shervin Eshaghian; Fernando Mendoza; Simon Biner; Bojan Cercek; Robert J Siegel Journal: Am J Cardiol Date: 2013-07-02 Impact factor: 2.778
Authors: M Szturmowicz; A Pawlak-Cieślik; A Fijałkowska; J Gątarek; A Skoczylas; M Dybowska; K Błasińska-Przerwa; R Langfort; W Tomkowski Journal: Support Care Cancer Date: 2017-03-03 Impact factor: 3.603
Authors: Eduardo M Vilela; Catarina Ruivo; Claudio E Guerreiro; Marisa P Silva; Ricardo Ladeiras-Lopes; Daniel Caeiro; Gustavo P Morais; João Primo; Pedro Braga; Nuno Ferreira; José Pedro L Nunes; Vasco Gama Ribeiro Journal: Ther Adv Cardiovasc Dis Date: 2018-08-15
Authors: Hui-Ming Chang; Tochukwu M Okwuosa; Tiziano Scarabelli; Rohit Moudgil; Edward T H Yeh Journal: J Am Coll Cardiol Date: 2017-11-14 Impact factor: 24.094
Authors: Bala Pushparaji; Teodora Donisan; Dinu V Balanescu; Nicolas Palaskas; Peter Kim; Juan Lopez-Mattei; Mehmet Cilingiroglu; Saamir A Hassan; Konstantinos Dean Boudoulas; Konstantinos Marmagkiolis; Ludhmila Abrahao Hajjar; Cezar A Iliescu Journal: Curr Oncol Rep Date: 2021-09-27 Impact factor: 5.075