Prognostic impact of minimal pericardial effusion in patients with advanced non–small cell lung cancer

• Published in: Clinical lung cancer Vol. 18; no. 6; pp. e449 - e455
• Main Authors: Kato, Ryoji, Hayashi, Hidetoshi, Chiba, Yasutaka, Tanaka, Kaoru, Takeda, Masayuki, Nakagawa, Kazuhiko
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2017
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma, Non-Small-Cell Lung - diagnostic imaging; Carcinoma, Non-Small-Cell Lung - pathology; Computed tomography; Female; Hematology, Oncology and Palliative Medicine; Hospitals, University; Humans; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - pathology; Male; Middle Aged; Neoplasm Staging; Non–small-cell lung cancer; Pericardial effusion; Pericardial Effusion - diagnostic imaging; Prognosis; Proportional Hazards Models; Pulmonary/Respiratory; Retrospective Studies; Stage IV; Survival Rate; Tomography, X-Ray Computed - methods; Young Adult; computed tomography; ALK; anaplastic lymphoma kinase gene; NSCLC; OS; epidermal growth factor receptor gene; non–small cell lung cancer; prognosis; EGFR; pericardial effusion; CT; PCE; stage IV; overall survival; PCR; polymerase chain reaction; Non–small-cell lung cancer; Prognosis; Stage IV; Computed tomography; Pericardial effusion
• ISSN: 1525-7304; 1938-0690
• DOI: 10.1016/j.cllc.2017.05.011

Abstract Introduction Minimal (<10 mm in thickness) pericardial effusion (PCE) can be incidentally detected by computed tomography at the time of diagnosis in lung cancer patients. Although malignant PCE is known to be associated with poor prognosis, the impact of minimal PCE on outcome has remained unclear. We therefore examined the prognostic relevance of minimal PCE in patients with advanced non–small cell lung cancer (NSCLC). Patients and Methods We retrospectively analyzed consecutive patients diagnosed with stage IV NSCLC at Kindai University Hospital between April 2009 and March 2015. The patients were classified into three groups on the basis of the presence and thickness of PCE: no PCE, minimal (<10 mm) PCE, and malignant (≥10 mm) PCE. The relation between overall survival (OS) and PCE status was examined with a Cox proportional hazard model. Results The total of 428 enrolled patients included 327 (76.4%) in the no PCE group, 61 (14.3%) in the minimal PCE group, and 40 (9.3%) in the malignant PCE group. Median OS was 15.0, 10.1, and 7.6 months in the no PCE, minimal PCE, and malignant PCE groups, respectively, with the survival of patients with minimal PCE thus being intermediate between that of the other two groups ( P = 0.003). Multivariable analysis revealed that minimal PCE was independently associated with reduced survival (hazard ratio of 1.46, with a 95% confidence interval of 1.07–1.96; P = 0.019). Conclusions The presence of minimal PCE was an independent prognostic factor for reduced survival in patients with advanced NSCLC.