In patients with malignant pericardial effusion, a subxiphoid pericardial window provides only short-term palliation with a median survival of 2.6 months, highlighting the need to carefully weigh surgical versus non-surgical options.
Poor prognosis after pericardial window in malignant effusion warrants cautious selection; leaves open comparative trials versus nonsurgical palliation.
The study reviews the survival of patients with malignant pericardial effusion treated with a subxiphoid pericardial window. The medical records of 60 consecutive patients diagnosed with a malignant pericardial effusion and treated with a subxiphoid pericardial window between 1994 and 2008 were reviewed. 72% had lung cancer. Overall 30-day mortality was 31%. Survival rates at 3 months, 6 months, 1 year, and 2 years were 45%, 28%, 17%, and 9%, respectively. Overall median survival was 2.6 months. Patients with malignant pericardial effusion, especially those with primary lung cancer have poor survival rates. In advanced malignancy, the subxiphoid pericardial window procedure provides only short-term palliation of symptoms, and has no effect on long-term survival. The use of any surgical procedure in patients with malignant advanced pericardial effusion should be considered along with non-surgical options on a case-by-case basis depending on symptoms, general status, and expected survival.
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Nguyen et al. (2011) studied this question.
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