Clinical Characteristics of Malignant Pericardial Effusion Associated with Recurrence and Survival / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: We evaluated clinical outcomes after drainage for malignant pericardial effusion with imminent or overt tamponade. MATERIALS AND METHODS: Between August 2001 and June 2007, 100 patients underwent pericardiocentesis for malignant pericardial effusion. Adequate follow-up information on the recurrence of pericardial effusion and survival status was available for 98 patients. RESULTS: Recurrence of effusion occurred in 30 patients (31%), all of whom were diagnosed with adenocarcinoma. Multivariate analysis indicated that adenocarcinoma of the lung (hazard ratio [HR], 6.6; 95% confidence interval [CI], 1.9 to 22.3; p=0.003) and progressive disease despite chemotherapy (HR, 4.3; 95% CI, 1.6 to 12.0; p=0.005) were independent predictors of recurrence. Survival rates three months after pericardiocentesis differed significantly with the type of primary cancer; the rates were 73%, 18%, 90% and 30% in patients with adenocarcinoma of the lung, squamous cell carcinoma of the lung, breast cancer and other cancers, respectively. CONCLUSION: Recurrence and survival of patients with malignant pericardial effusion are dependent on the type of primary cancer and response to chemotherapy. Patients with adenocarcinoma of the lung may be good candidates for surgical drainage to avoid repeated pericardiocentesis, but pericardiocentesis is considered effective as palliative management in patients with other cancers.

Neoadjuvant Chemotherapy Decreases the Identification Rate of Sentinel Lymph Node Biopsy / 한국유방암학회지

PURPOSE: We investigated the feasibility and clinical applicability of sentinel lymph node biopsy (SLNB) in patients with neoadjuvant chemotherapy, tumor size > 2 cm, and privious excisional biopsy. METHODS: 175 patients with 176 breast cancer underwent aLNB between October 2001 and October 2002. Among them twenty-five patients with locally advanced breast cancer underwent SLNB after neoadjuvant chemotherapy. Eighty-nine (50.6%) had primary tumor > 2 cm. The recent biopsy method used before SLNB was excision in thirty-one (17.6%) procedures. The identification rate, false-negative rate, negative prediction value and accuracy of SLNB were determined. RESULTS: SLNB was successful in 164 of 176 cases (detection rate, 93.2%). The identification rate of patients who had neoadjuvant chemotherapy was 68% and lower than that of who had not (97.3%), significantly (P=0.00). However, mapping success was not influenced by large tumor size (> 2 cm) or previous excisional biopsy. The false-negative rate and accuracy were 16.5% and 91.5, respectively. The false negative rate was 21.3% (3/14) in those patients received neoadjuvant chemotherapy compared with a 15.5% in those patents not received neoadjuvant chemotherapy (P> 0.05). In addition, Tumor size > 2 cm and previous excision did not adversely impact the false negative rate and accuracy. CONCLUSION: Neoadjuvant chemotherapy was associated with a lower identification rate for SLNB. But if detected, SLNB after neoadjuvant chemotherapy might reliably predict axillary status. SLNB is feasible and accurate in patients with large tumor (> 2 cm) and previous excision.