Cardiology Clinic, National Cancer Center, Goyang, Korea.
Cancer Res Treat. 2010 Dec;42(4):210-6. doi: 10.4143/crt.2010.42.4.210. Epub 2010 Dec 31.
We evaluated clinical outcomes after drainage for malignant pericardial effusion with imminent or overt tamponade.
Between August 2001 and June 2007, 100 patients underwent pericardiocentesis for malignant pericardial effusion. Adequate follow-up information on the recurrence of pericardial effusion and survival status was available for 98 patients.
Recurrence of effusion occurred in 30 patients (31%), all of whom were diagnosed with adenocarcinoma. Multivariate analysis indicated that adenocarcinoma of the lung (hazard ratio [HR], 6.6; 95% confidence interval [CI], 1.9 to 22.3; p=0.003) and progressive disease despite chemotherapy (HR, 4.3; 95% CI, 1.6 to 12.0; p=0.005) were independent predictors of recurrence. Survival rates three months after pericardiocentesis differed significantly with the type of primary cancer; the rates were 73%, 18%, 90% and 30% in patients with adenocarcinoma of the lung, squamous cell carcinoma of the lung, breast cancer and other cancers, respectively.
Recurrence and survival of patients with malignant pericardial effusion are dependent on the type of primary cancer and response to chemotherapy. Patients with adenocarcinoma of the lung may be good candidates for surgical drainage to avoid repeated pericardiocentesis, but pericardiocentesis is considered effective as palliative management in patients with other cancers.
评估伴有即将发生或明显心脏压塞的恶性心包积液引流的临床转归。
2001 年 8 月至 2007 年 6 月期间，100 例行心包穿刺术治疗恶性心包积液的患者。98 例患者获得了有关心包积液复发和生存状态的充分随访信息。
30 例（31%）患者出现积液复发，均诊断为腺癌。多因素分析表明，肺腺癌（危险比[HR]，6.6；95%置信区间[CI]，1.9 至 22.3；p=0.003）和尽管接受化疗但病情进展（HR，4.3；95%CI，1.6 至 12.0；p=0.005）是复发的独立预测因素。心包穿刺术后 3 个月的生存率与原发癌的类型显著相关；肺腺癌、肺鳞癌、乳腺癌和其他癌症患者的生存率分别为 73%、18%、90%和 30%。
恶性心包积液患者的复发和生存取决于原发癌的类型和对化疗的反应。肺腺癌患者可能是手术引流的良好候选者，以避免反复心包穿刺，但心包穿刺术被认为是其他癌症患者的有效姑息治疗手段。
