title: Prognostic factors affecting survival of patients with cancer-related pericardial effusion managed by surgery.
abstract: BACKGROUND
  Although pericardial effusion (PE) is not uncommon in patients with cancer, it may lead to cardiac tamponade, a life-threatening condition. Prompt life-saving treatment is essential, and also allows the continuation of the cancer treatment. The aim of this study was to determine the prognostic factors for survival in patients with cancer who were treated surgically for PE.
  
  
  METHODS
  We retrospectively reviewed the medical records of 55 patients with cancer with PE between January 2003 and October 2012, who were treated with a pericardial window operation. Overall survival (OS) was estimated from the date of surgery, and patients were followed until the time of the final visit or time of death. Clinical outcomes and candidate prognostic factors were analyzed.
  
  
  RESULTS
  The median age of patients was 57 years (range 29 to 82 years), and 31 patients (56.4%) were male. The most common primary malignancy was lung cancer (65.5%), followed by breast cancer (10.9%). Fifteen patients (27.3%) developed recurrence of PE after surgery. The median OS duration was 4 months (range 0 to 39 months). Multivariate analysis found that evidence of pericardial metastasis on preoperative imaging (P = 0.029) and confirmation of malignant cells in the PE and/or pericardial tissue (P = 0.034) were associated with reduced OS.
  
  
  CONCLUSIONS
  Evidence of pericardial metastasis on preoperative imaging and cytopathologic confirmation that the PE and/or pericardial tissue are positive for malignant cells can be used to predict poor clinical outcomes in patients with cancer-related PE.
authors.forename: Hyun Woo
authors.initials: HW
authors.lastname: Jeon
authors.forename: Deog Gon
authors.initials: DG
authors.lastname: Cho
authors.forename: Jae Kil
authors.initials: JK
authors.lastname: Park
authors.forename: Kwan Yong
authors.initials: KY
authors.lastname: Hyun
authors.forename: Si Young
authors.initials: SY
authors.lastname: Choi
authors.forename: Jong Hui
authors.initials: JH
authors.lastname: Suh
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Bucheon St, Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seoul 137-701, Seocho-gu, Republic of Korea. ydkim@catholic.ac.kr.
authors.forename: Young-Du
authors.initials: YD
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002305:Cardiac Tamponade / Q000209:etiology / Q000401:mortality / Q000601:surgery; D019468:Disease Management; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010490:Pericardial Effusion / Q000209:etiology / Q000401:mortality* / Q000601:surgery*; D010491:Pericardial Window Techniques / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
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