title: Resection of thoracic malignancies infiltrating cardiac structures with use of cardiopulmonary bypass.
abstract: BACKGROUND
  Only few reports exist on malignant thoracic neoplasms that require cardiopulmonary bypass during resection. We aimed to investigate the early and late clinical outcome of these patients.
  
  
  METHODS
  Patients with thoracic malignancies that underwent surgery between 2002 and 2014 were analyzed. All patients had cardiopulomonary bypass support during resection. Clinical and perioperative data was retrospectively reviewed for outcome and overall survival.
  
  
  RESULTS
  Fifteen patients (12 female, mean age of 55 ± 15 years, range 24 to 80 years) were identified. Eleven (8 female) were diagnosed with primary thoracic malignomas and four with metastases. Three patients died early postoperatively. Patients diagnosed with sarcoma had a significantly worse outcome than non-sarcoma patients (83.3 ± 15.2 % after 1 year, 31.3 ± 24.5 % after 5 years vs. 83.3 ± 5.2 % after 1 year, 0 ± 0 % after 5 years, p = 0.005).
  
  
  CONCLUSIONS
  Malignancies with extension into cardiac structures or infiltration of great vessels can be resected with cardiopulmonary bypass support and tolerable risk. Carefully selected patients can undergo advanced operative procedures with an acceptable 1-year-survival, but only few patients achieved good long-term outcome.
authors.affiliation: Department of Cardiac Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. rawa.arif@med.uni-heidelberg.de.
authors.forename: Rawa
authors.initials: R
authors.lastname: Arif
authors.affiliation: Department of Thoracic Surgery, Thoraxklinik Heidelberg, University Hospital Heidelberg, Heidelberg, Germany. florian.eichhorn@med.uni-heidelberg.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Eichhorn
authors.affiliation: Department of Cardiac Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. klaus.kallenbach@med.uni-heidelberg.de.
authors.forename: Klaus
authors.initials: K
authors.lastname: Kallenbach
authors.affiliation: Department of Cardiac Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. philipp.seppelt@med.uni-heidelberg.de.
authors.forename: Philipp
authors.initials: P
authors.lastname: Seppelt
authors.affiliation: Department of Cardiac Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. arjang.ruhparwar@med.uni-heidelberg.de.
authors.forename: Arjang
authors.initials: A
authors.lastname: Ruhparwar
authors.affiliation: Department of Thoracic Surgery, Thoraxklinik Heidelberg, University Hospital Heidelberg, Heidelberg, Germany. hendrik.dienemann@med.uni-heidelberg.de.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Dienemann
authors.affiliation: Department of Cardiac Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. matthias.karck@med.uni-heidelberg.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Karck
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002315:Cardiopulmonary Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012509:Sarcoma / Q000175:diagnosis / Q000601:surgery*; D013899:Thoracic Neoplasms / Q000175:diagnosis / Q000601:surgery*; D019616:Thoracic Surgical Procedures / Q000379:methods*; D014057:Tomography, X-Ray Computed; D055815:Young Adult