Neoplastic Pericardial Effusion: A Monocentric Retrospective Study

Elisabetta Di Liso, Alice Menichetti, Maria Vittoria Dieci, Cristina Ghiotto, Alberto Banzato, Alessandra Bianchi, Giovanna Pintacuda, Marta Padovan, Floriana Nappo, Enrico Cumerlato, Federica Miglietta, Eleonora Mioranza, Giulia Zago, Luigi Corti, Valentina Guarneri, Pierfranco Conte

Research output: Contribution to journalArticle

Abstract

Background: Neoplastic pericardial effusion (NPE) is a life-threatening condition that can worsen clinical outcome in cancer patients. The optimal management of NPE has yet to be defined because randomized studies are lacking. Objective: We report a retrospective monoinstitutional experience describing characteristics, management and prognostic factors in NPE patients. Design: We reviewed clinical, pathological, and echocardiographic features, therapeutic strategies, and outcome in NPE patients referred to our institute from August 2011 to December 2017. Measurements: Twenty-nine patients with NPE from solid tumors have been identified: 21 lung, 5 breast, and 3 other cancer patients. Results: Median age was 62 years. Most of the patients had Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥2 (69%) and a symptomatic NPE (69%). In 52% of patients NPE was detected at first diagnosis of metastatic disease, and in 20% of patients pericardium was the only site of metastases. Most of the patients (62%) received systemic therapy, 28% received combined locoregional and systemic therapy, and 10% received locoregional therapy alone. Median overall survival (OS) from NPE diagnosis was 3.9 months. Patients with PS ≥2 had worse OS than patients with better PS <2 (hazard ratio [HR] 3.56, IC 95% 1.19-10.65, p 0.02). Older age, extrapericardial disease, and NPE at progression showed a trend of association with worse OS. Patients treated with locoregional therapy alone showed the shortest median OS (p 0.05). Conclusions: NPE is related to dismal prognosis. Poor PS significantly worsens survival and influences therapeutic approaches. Randomized studies are required to investigate prognostic factors and appropriate clinical management for patients with NPE.

Original languageEnglish
Pages (from-to)691-695
Number of pages5
JournalJournal of Palliative Medicine
Volume22
Issue number6
DOIs
Publication statusPublished - Jun 2019

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