Safety and Outcome of Percutaneous Drainage of Pericardial Effusions in Patients with Cancer

Malignancy is a common cause of pericardial effusions. The findings, immediate safety and longer-term outcomes of pericardiocentesis are less well defined. We reviewed the cases of all patients with malignancy that underwent pericardiocentesis at our institution over a 10-year period. From January 1, 2007 to December 31, 2016, 171 patients with cancer underwent echo-guided pericardiocentesis. A total of 53% were male with a mean age of 60 ± 15 years. The average volume drained was 485 (IQR 350 to 719) ml. The procedure was technically successful in 170/171 (99.4%) of patients without significant complications; there were no procedure-related deaths. A total of 20% had hemorrhagic, 48% had serosanguinous, and 31% serous pericardial effusions. The type of effusion was not associated with outcome. Cytology (measured in 164) was positive in 58% and only weakly related to outcome (median survival nine versus 18 weeks, p = 0.04). Per our institutional practice, a pericardial catheter was left in place until there were less than 50 ml of net drainage in 24 hours (average 3 ± 2 days). A total of 135 patients had metastatic carcinoma, 23 patients had lymphoma or chronic leukemia and 4 metastatic sarcoma. Patients with either lymphoma or chronic leukemia had better survival than those with carcinoma or sarcoma (median survival 102 vs 12 weeks, p