Cardiac surgery with extracorporeal circulation and concomitant malignancy: early and long-term results.
J Cardiovasc Med (Hagerstown)
; 17(2): 152-9, 2016 Feb.
Article
em En
| MEDLINE
| ID: mdl-26556442
ABSTRACT
AIMS:
We retrospectively evaluated early and long-term results of cardiac surgery using extracorporeal circulation (ECC) in patients affected by malignancies and the potential influence of ECC on malignancy progression during follow-up.METHODS:
Out of 7078 patients referred for cardiac surgery from January 2001 to December 2012, 241 consecutive patients (3.4%) (mean age 72â±â8âyears; men 170) had malignancy either known before or detected during hospital stay. Organ malignancies were present in 201 patients (83%) and hematological malignancies in 40 (17%). Early stages of cancer (I-II, in remission) were present in 180 (75%) patients, and advanced stages (III-IV for organ malignancies , multiple organ involvement for hematological malignancies) in 61 (25%). EuroSCORE I and II were 8.6â±â5.4 and 3.8â±â2.1%, respectively. Cardiac surgery with ECC consisted in isolated (nâ=â176) or multiple procedures (nâ=â65). Follow-up (mean 57â±â40âmonths) was 99% complete.RESULTS:
In-hospital mortality was 5.8% (nâ=â14); 1.67% (nâ=â4) died from cancer-related causes. Ten-year survival was 65â±â5%, and freedom from cardiac death was 92â±â3.5%. Freedom from cancer-related death was 90â±â3% for patients operated on in early stages of cancer compared with 60â±â8.4% for those who operated on in advanced stages (Pâ<â0.0001), and 89â±â2.6% for organ malignancies compared with 48â±â13% for hematological malignancies (Pâ=â0.0002); hematological malignancies different from Hodgkin/non-Hodgkin lymphoma affected long-term survival (Pâ<â0.05). Progression of malignancy was observed in 29 patients (12.8%) at 18â±â10âmonths.CONCLUSION:
Cardiac surgery in cancer patients is not associated with increased in-hospital mortality and provides satisfactory freedom from cardiac death. Long-term survival in early stages of cancer appears satisfactory. Time interval between ECC and progression of malignancy during follow-up should apparently exclude a close relationship of ECC on cancer progression. Hematological malignancies seem to have a negative impact on the overall outcome.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Circulação Extracorpórea
/
Cardiopatias
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Procedimentos Cirúrgicos Cardíacos
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Neoplasias
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
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Humans
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Male
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article