Source: Annual Congress 2002 - Lung cancer: epidemiology and clinical characteristics
Disease area: Thoracic oncology

Abstract

Malignant cardiac tamponade is a life threatening condition. Early diagnosis and intensive local treatment may improve prognosis in some patients (pts). 33 pts, 25 men, 8 women, median age 53 years with large malignant effusion due to metastatic lung cancer (mostly adenocarcinoma) were treated with pericardiocenthesis or pericardiotomy and pericardial fluid (pf) drainage. Pf cytology was positive in 73% of cases. Cyfra 21-1 exceeding 50 ng/ml was found in 83%, CEA exceeding 5 ng/ml in 82% of pf. Positive pf CEA, Cyfra 21-1 or both were found in all of cases with negative pf cytology. 28/33 pts received intrapericardial cisplatin treatment. Pf drainage could be discontinued in most pts shortly after cisplatin administration. 13/33 pts received additional systemic chemotherapy. Median survival in the whole group of pts was 3 months, in the group receiving both local and systemic chemotherapy - 5 months, with 3/13 pts surviving more than 1 year. None of the pts died of cardiac tamponade. Conclusions: Cyfra 21-1 and CEA evaluation in pf is complementary to cytologic examination in the recognition of malignant pericarditis due to lung cancer. Intrapericardial cisplatin treatment combined if possible with systemic chemotherapy may improve quality of life and prolong survival in this fatal condition.

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M. Szturmowicz, W. Tomkowski, A. Fijakowska, J. Burakowski, W. Kupis, J. Gontarek, R. Langfort, A. Sakowicz, T. M. Orowski, A. Torbicki (Warsaw, Poland). Neoplastic pericardial involvement as a first sign of lung cancer - diagnosis and treatment. An analysis of 33 patients treated in ICU. Eur Respir J 2002; 20: Suppl. 38, 572

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