Clinical Features and Treatment Outcome of Carcinomatous Pericarditis due to Lung Cancer.

Backgrounds: Carcinomatous pericarditis is a disease with poor prognosis. Its treatment consist of systemic chemotherapy and topical therapies which includes pericardial drainage or intra-pericardial chemotherapy. We do not know the prognosis when additional treatments after pericardial drainage are performed. Objectives: Our study aim was to clarify clinical features of patients with carcinomatous pericarditis due to lung cancer and to estimate prognosis when additional therapies of intra-pericardial chemotherapy ± systemic chemotherapy were performed after pericardial drainage. Methods: We retrospectively investigated clinical features and prognosis of 57 patients who were pathologically diagnosed carcinomatous pericarditis due to lung cancer from January 1995 to December 2017. Results: Patients characteristics were 36 males and 21 females, with median age 66.0 years (41-82). Performance status was 0-2(n=0) and 3-4(n=57). All cases were equivalent to cardiac tamponade. Cell types were Ad (n=47), Sq (n=8) and Small (n=2). The median time from the diagnosis of lung cancer to the onset of carcinomatous pericarditis was 71days (Ad;35 days, Sq;399 days, Small 232 days (p=0.158)). We defined 3 groups (A; pericardial drainage + intra-pericardial chemotherapy+ systemic chemotherapy, B; pericardial drainage + intra-pericardial chemotherapy, C; pericardial drainage only). The median survival time after the onset of carcinomatous pericarditis were A;218 days, B;98 days, and C;17 days (p＝0.006). Conclusions: The prognosis of carcinomatous pericarditis due to lung cancer improved by adding both intra-pericardial chemotherapy and systemic chemotherapy to pericardial drainage.