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Review
. 2005 Nov 28;11(44):6899-904.
doi: 10.3748/wjg.v11.i44.6899.

Clinicopathological study of cardiac tamponade due to pericardial metastasis originating from gastric cancer

Michiya Kobayashi  1 , Takehiro Okabayashi, Ken Okamoto, Tsutomu Namikawa, Keijiro Araki
Affiliations
Review

Clinicopathological study of cardiac tamponade due to pericardial metastasis originating from gastric cancer

Michiya Kobayashi et al. World J Gastroenterol. .

Abstract

Aim: To review the cases reported in the literature, examined their clinicopathological features, and evaluated the efficacy of different therapeutic modalities for this rare condition.

Methods: A search of the MEDLINE database revealed 16 cases of pericarditis carcinomatosa (PC) originating from GC reported in the literature between 1982 and 2005. Additional detailed data were obtained from the authors of these studies for subsequent clinicopathological investigation. We have also described about a case study from our own clinic.

Results: The mean age of cases with pericarditis carcinomatosa originating from GC was 54 years. Females were diagnosed at a younger age (46.3 years) compared to males (58 years). The mean survival period after diagnosis was 4.5 mo. No statistical differences in the length of survival time were found between different therapeutic modalities, such as drainage, and local and/or systemic chemotherapy after drainage. However, three cases who underwent systemic chemotherapy survived for more than 10 mo. Cases that developed metachronous cardiac tamponade for more than 2 years after the diagnosis of GC generally survived for a longer period of time, although this was not statistically significant. Multivariate analysis revealed that low levels of carcinoembryonic antigen (CEA), and CEA and/or cancer antigen 19-9 (CA 19-9) were associated with longer survival.

Conclusion: Cases with low levels of CEA, and CEA and/or CA 19-9 should undergo systemic chemotherapy with or without local chemotherapy after drainage.

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Figures

Figure 1
Figure 1
Kaplan-Meier survival curve of all cases (n = 17).
Figure 2
Figure 2
Kaplan-Meier survival curve according to administration of systemic chemotherapy. The cases treated with systemic chemotherapy were more likely to survive longer (P = 0.0579) than those who were not treated with systemic chemotherapy.
Figure 3
Figure 3
Kaplan-Meier survival curve according to time period between the diagnosis of gastric cancer and diagnosis of cardiac tamponade. The cases in whom cardiac tamponades were diagnosed for more than 24 mo after the diagnosis with gastric cancer were more likely to survive longer than those in whom cardiac tamponade was diagnosed for less than 24 mo after the initial diagnosis of gastric cancer. However, there was no statistical difference between the two groups (P = 0.1130).
Figure 4
Figure 4
Kaplan-Meier survival curve according to CEA levels. The cases with normal CEA levels had a longer survival period as compared to those with high CEA levels (P = 0.0071).
See this image and copyright information in PMC

References

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