Suzuki Shuichi, Usui Akihiko, Yoshida Katsuhiko, Matsuura Akio, Ichihara Toshihiko, Ueda Yuichi
Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Showa-ku, Aichi, Japan.
Asian Cardiovasc Thorac Ann. 2010 Dec;18(6):536-40. doi: 10.1177/0218492310388453.
Adverse effects of cardiopulmonary bypass on cancer prognosis are expected but have not been confirmed. Seventy-four cancer patients who underwent cardiac surgery before cancer therapy were followed up for 42 ± 37 months; 45 had cardiac surgery with cardiopulmonary bypass. There was no significant difference in cancer recurrence (40.0%) and deaths (26.7%) among patients who had cardiopulmonary bypass and those who underwent off-pump cardiac surgery (27.6% and 24.1%). There were no significant differences in freedom from cancer-related death at 2 and 5 years after cardiac surgery (78.4% and 68.5%) in the cardiopulmonary bypass group compared to the 29 off-pump group (81.8% and 58.3%). Despite some limitations, this study detected no significant adverse effects of cardiopulmonary bypass on cancer prognosis. Although these results do not verify the safety of cardiopulmonary bypass from an oncologic aspect, they suggest it can be applied in cancer patients who require cardiac surgery.
体外循环对癌症预后的不良影响虽可预期，但尚未得到证实。74例在癌症治疗前接受心脏手术的癌症患者接受了42±37个月的随访；其中45例接受了体外循环心脏手术。接受体外循环手术的患者与接受非体外循环心脏手术的患者（分别为27.6%和24.1%）在癌症复发率（40.0%）和死亡率（26.7%）方面无显著差异。与29例非体外循环组相比，体外循环组心脏手术后2年和5年的无癌症相关死亡生存率（分别为78.4%和68.5%）与非体外循环组（分别为81.8%和58.3%）无显著差异。尽管存在一些局限性，但本研究未发现体外循环对癌症预后有显著不良影响。虽然这些结果并未从肿瘤学角度证实体外循环的安全性，但表明其可应用于需要心脏手术的癌症患者。
