Prognostic relevance of pericardial effusion in patients with malignant diseases

which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Table 1. Etiological diagnosis and frequency of pericardial involvement in malignant diseases. Prognostic relevance of pericar-dial effusion in patients with malignant diseases TO THE EDITOR: Malignancy is a common cause of peri-cardial effusion, and malignant pericardial effusion is a serious manifestation in advanced malignancies [1]. Malignancy-related pericardial effusion is associated with significantly decreased patient survival [1]. Slight malignant pericardial effusions are frequently asymptomatic; however, symptomatic patients often present with cardiac tamponade, which can rapidly lead to cardiovascular collapse or death [2]. Therefore, early diagnosis and timely treatment may decrease a patient's short-term risk of death. We evaluated both the etiology and prognosis of pericardial involvement in several malignancies. We retrospectively reviewed the records of 215 patients (126 males and 89 females) with pericardial effusion and malignant diseases, including solid tumors and hemato-logical malignancies, from January 1991 to December 2010. In all cases, the clinical diagnosis was confirmed by pathological examination of the primary tumor site. All patients underwent pericardiocentesis, and pericardial fluid analyses were performed for cytology. We analyzed the incidence of the etiology of malignancies and overall survival according to the results of the pericardial fluid analysis. Overall survival was calculated from the day of initial diagnosis to the date of patient's death from any other cause or to the latest follow-up date. Among 215 patients, 113 (52.6%) showed pericardial involvement in their malignant diseases. The etiological diagnosis and pericardial fluid analysis results are summarized in Table 1. Pericardial involvement of malignancy was most frequent in breast carcinoma (85.0%), followed by lung adenocarcinoma (61.9%), gastric adenocarcinoma (58.8%), thymic carcinoma (33.3%), and esophageal squamous cell