Gastric Cancer
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2005; 11(44): 6899-6904
Published online Nov 28, 2005. doi: 10.3748/wjg.v11.i44.6899
Clinicopathological study of cardiac tamponade due to pericardial metastasis originating from gastric cancer
Michiya Kobayashi, Takehiro Okabayashi, Ken Okamoto, Tsutomu Namikawa, Keijiro Araki
Michiya Kobayashi, Takehiro Okabayashi, Ken Okamoto, Tsutomu Namikawa, Keijiro Araki, Department of Tumor Surgery, Kochi Medical School, Nankoku 783-8505, Japan
Author contributions: All authors contributed equally to the work.
Supported by KOBAYASHI MAGOBE Memorial Medical Foundation
Correspondence to: Michiya Kobayashi, MD, PhD, Department of Tumor Surgery, Kochi Medical School, Oko-cho, Nankoku, Kochi 783-8505, Japan.
Telephone: +81-888-80-2370 Fax: +81-888-80-2371
Received: May 2, 2005
Revised: July 15, 2005
Accepted: July 19, 2005
Published online: November 28, 2005

AIM: To review the cases reported in the literature, examined their clinicopathological features, and evaluated the efficacy of different therapeutic modalities for this rare condition.

METHODS: A search of the MEDLINE database revealed 16 cases of pericarditis carcinomatosa (PC) originating from GC reported in the literature between 1982 and 2005. Additional detailed data were obtained from the authors of these studies for subsequent clinicopathological investigation. We have also described about a case study from our own clinic.

RESULTS: The mean age of cases with pericarditis carcinomatosa originating from GC was 54 years. Females were diagnosed at a younger age (46.3 years) compared to males (58 years). The mean survival period after diagnosis was 4.5 mo. No statistical differences in the length of survival time were found between different therapeutic modalities, such as drainage, and local and/or systemic chemotherapy after drainage. However, three cases who underwent systemic chemotherapy survived for more than 10 mo. Cases that developed metachronous cardiac tamponade for more than 2 years after the diagnosis of GC generally survived for a longer period of time, although this was not statistically significant. Multivariate analysis revealed that low levels of carcinoembryonic antigen (CEA), and CEA and/or cancer antigen 19-9 (CA 19-9) were associated with longer survival.

CONCLUSION: Cases with low levels of CEA, and CEA and/or CA 19-9 should undergo systemic chemotherapy with or without local chemotherapy after drainage.

Keywords: Gastric cancer, Pericarditis carcinomatosa, Cardiac tamponade, Chemotherapy