Cardiopulmonary bypass does not consequentially contribute to postoperative distant metastasis of giant refractory thoracic tumors: A retrospective study with long‐term follow‐up

Abstract

Background Few clinical research studies with long‐term follow‐up have revealed whether cardiopulmonary bypass (CPB) increases the risk of postoperative distant metastasis in patients with giant refractory thoracic tumors. The present study evaluated the risk of distant metastasis after surgery utilizing CPB with long‐term follow‐up. Methods Clinical data for patients with giant refractory thoracic tumors who underwent resection with the use of CPB in the Second Affiliated Hospital of Soochow University during the past 11 years were retrospectively reviewed. Results Of the 14 patients with giant refractory thoracic tumors who had undergone surgery under CPB, 10 patients (71.4%) were completely resected. Twelve patients were followed up for 13–127 months with 10 patients were completely resected and two patients could not be completely resected due to severe tissue invasion. Three patients (25%) suffered from distant metastasis, and four patients (33.3%) experienced local recurrence. Only one patient (1/10) with complete resection suffered from distant metastasis, while two patients (2/10) experienced local recurrence. Two patients (2/2) with major resection suffered from both distant metastasis and local recurrence. Median overall survival for patients who have been regularly followed up was 50 months with 1‐, 5‐, and 10‐year survival of 100%, 75%, and 66.7%. No difference was found between the distant metastasis survival and the local recurrence survival. (p = 0.99). Conclusions CPB is an effective strategy for complete resection of the giant refractory thoracic tumors with an acceptable risk of postoperative distant metastasis for some patients.

Case report: Complete resection of invasive thymoma invading the superior vena cava and right atrium under cardiopulmonary bypass support

“…Studies have shown that using CPB does not appear to increase the risk of tumor dissemination. For patients with locally advanced cancers, CBP can safely help remove the tumor and improve the survival to a certain extent ( 17 , 18 ).…”

Coronary artery bypass grafting in patients with malignancy: a single-institute case series of eight patients

“…Tønnesen's study demonstrated that extracorporeal circulation inhibits the cytotoxic function of natural killer (NK) cells against tumor cells and causes a decrease in complement, lymphocytes, and neutrophils [24]. Chen and colleagues [25] found that extracorporeal circulation was acceptable for the risk of distant metastases after complete resection of thoracic malignancies in 14 cases of massive thoracic tumors resected under extracorporeal circulation with long-term follow-up. In addition, several reports comparing on-pump and off-pump CABG in cancer patients have shown no significant major adverse effect of extracorporeal circulation on cancer recurrence and late-stage survival [10,11,26].…”

Perioperative management and postoperative outcomes of locally advanced thymic epithelial tumors: a narrative review

“…Several reports exist regarding the complete resection of TETs with aortic or cardiac invasion using cardiopulmonary bypass, yielding relatively favorable outcomes ( 46 - 48 ). The risk of systemic dissemination of tumor cells while employing cardiopulmonary bypass is deemed acceptable and seems to be low when juxtaposed with the risk of hematogenous tumor cell dissemination triggered by vascular invasion of malignant thymoma or thymic carcinoma ( 49 , 50 ).…”