Key result
Cardiopulmonary bypass is not meaningfully linked to cancer progression and should not contraindicate cardiac surgery.
Why the study?
The benefits and risks of cardiopulmonary bypass (CPB) cardiac surgery on cancer dissemination and long-term survival in patients with cancer are not yet established.
Does cardiopulmonary bypass increase the risk of cancer dissemination in patients with cancer undergoing cardiac surgery?
Does cardiopulmonary bypass increase the risk of cancer dissemination in patients with cancer undergoing cardiac surgery?
Despite theoretical risks of immunologic and inflammatory changes, cardiopulmonary bypass is unlikely to significantly increase cancer dissemination in patients with concurrent malignancies.
May support cardiac surgery with cardiopulmonary bypass in cancer patients; leaves open need for prospective confirmation.
Early cancer diagnosis, new therapies that increased survival of patients, besides the increasingly elderly population are some factors would be associated with possible cancer dissemination in patients under cardiopulmonary bypass (CPB) cardiac surgery. Also, the benefits, and risks, regarding long-term survival, have not yet been established. Therefore, cardiac surgery morbimortality may be superior in patients with cancer disease. Also, immunologic and inflammatory changes secondary to CPB can also increase tumor recurrence. After a brief introduction and CPB immunologic the two main topic subjects included: 1) Combined heart surgery and lung resection and; 2) Possible influence of neoplasia type. After observing the relative literature scarcity, we keep the opinion that "CPB has a modest association with cancer progression" and that "CPB and cancer dissemination should be a logical but unlikely association."
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Évora et al. (2018) conducted a review in Cancer and cardiac disease requiring cardiopulmonary bypass. Cardiopulmonary bypass was evaluated on Cancer dissemination or progression. Cardiopulmonary bypass has a modest and unlikely association with cancer progression, suggesting it should not be considered a contraindication for cardiac surgery in patients with malignancies.
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