Neoplastic Pericardial Effusion: A Monocentric Retrospective Study.

Area of Science:

• Oncology
• Cardiology
• Clinical Medicine

Background:

• Neoplastic pericardial effusion (NPE) is a critical complication in cancer patients, often associated with poor prognosis.
• Optimal management strategies for NPE remain undefined due to a lack of randomized controlled trials.

Purpose of the Study:

• To describe the characteristics, management, and prognostic factors of patients with neoplastic pericardial effusion.
• To evaluate the impact of performance status and treatment modalities on overall survival in NPE patients.

Main Methods:

• Retrospective analysis of 29 patients with solid tumors and NPE treated at a single institution from August 2011 to December 2017.
• Review of clinical, pathological, echocardiographic data, therapeutic interventions, and patient outcomes.
• Statistical analysis to identify factors associated with overall survival.

Main Results:

• The median age of patients was 62 years, with most having ECOG performance status ≥2 (69%) and symptomatic NPE (69%).
• NPE was diagnosed at initial metastatic disease presentation in 52% of cases; the pericardium was the sole metastatic site in 20%.
• Median overall survival (OS) from NPE diagnosis was 3.9 months. Poor performance status (PS ≥2) significantly correlated with worse OS (HR 3.56, p=0.02). Patients receiving locoregional therapy alone had the shortest OS (p=0.05).

Conclusions:

• Neoplastic pericardial effusion is associated with a dismal prognosis.
• Poor performance status is a significant negative prognostic factor and influences therapeutic decisions.
• Further randomized studies are essential to define prognostic factors and optimal clinical management for NPE.