Effect of the primary tumor on outcomes after the pleuropericardial window in malignant pericardial effusion

Introduction Malignant pericardial effusion (MPE) is uncommon in advanced-stage cancer. However, MPE can result in a life-threatening condition such as cardiac tamponade. Surgical drainage is routinely recommended as a rapid and effective treatment for this disease. This study aims to investigate the overall outcome after pleuropericardial window surgery in patients with MPE. Method This study enrolled 148 patients with MPE who underwent pleuropericardial window surgery from 1990 to 2020. The patients were grouped based on their history of lung cancer or nonlung cancer. A Kaplan–Meier survival analysis was performed to compare the two groups of patients. Depending on the variable type, the chi-square test, t test, or the Mann–Whitney U test was used to compare the two groups in terms of intraoperative and postoperative outcomes. Cox regression analysis was performed to demonstrate the mortality risk. Results A total of 148 patients underwent pleuropericardial window surgery during the study period; 92 patients had lung cancer, and 56 patients had nonlung cancer. In the subgroup analysis, there was no difference in age, underlying disease, or surgical approach. With regard to intraoperative outcomes, no differences were observed in hospital stay or postoperative complications. The Kaplan–Meier survival analysis revealed that patients with nonlung cancer survived longer than those with lung cancer did ( p = .001). Conclusion Pleuropericardial window surgery is a safe and effective procedure with acceptable postoperative outcomes. Among patients who have undergone this surgery, the presence of lung cancer, as compared with nonlung cancer, worsened their survival rate.