• Hadrien Portefaix, Grégory Papin, Elie Kantor, Bernard Iung, Philippe Montravers, Dan Longrois, and Sophie Provenchère.
• Anaesthesiology and Critical Care Department, DMU PARABOL, AP-HP, Bichat Hospital, Paris, France.
• J. Cardiothorac. Vasc. Anesth. 2022 Jul 1; 36 (7): 1934-1941.

ObjectivesCardiac surgery increasingly is being performed in patients with a history of or with active cancer. The aim of this study was to analyze the association between a history of cancer and 1-year mortality after cardiac surgery with cardiopulmonary bypass (CPB).DesignAn observational monocentric study, with data collected from a prospective institutional database was conducted.SettingA single academic center.ParticipantsAll consecutive patients undergoing cardiac surgery with CPB between 2005 and 2017.InterventionNone.MethodsA history of cancer was preoperatively identified. Mortality rates were estimated by the Kaplan-Meier method. The 1-year mortality risk of patients with and without cancer was compared using a multivariate Cox model.Measurements And Main ResultsDuring the study period, 12,143 patients underwent cardiac surgery with CPB, including 4,681 (39%) isolated coronary artery bypass surgeries. Their median EuroSCORE II was 3.1, interquartile range 1.5-to-6.4. Nine hundred thirty patients (8%) had a diagnosis of cancer, out of whom 469 (50%) were diagnosed ≤5 years before the index surgery; 103 (11%) patients had hemopathy, and 825 (89%) had solid cancers. The estimated unadjusted 1-year mortality was significantly higher among patients with cancer, 11% (95% confidence interval [CI] 10-14) versus 8% (95%CI 7-9) p < 0.01. After adjustment, a diagnosis of cancer was not associated with the risk of 1-year mortality (adjusted hazard ratio = 1.17 [95%CI 0.96-1.43]; p = 0.13).ConclusionsIn a large cohort of patients undergoing cardiac surgery with CPB, cancer was not independently associated with 1-year mortality. An isolated cancer history should not lead to denial of cardiac surgery. The impact of cancer on complications and long-term survival after cardiac surgery requires further research.Copyright © 2021 Elsevier Inc. All rights reserved.

18 keywords...

hide…