Pericardiocentesis with cisplatin for malignant pericardial effusion and tamponade

Abstract

To evaluate the role and outcome of pericardiocentesis with intrapericardial cisplatin instillation for malignant pericardial effusion resulting from esophageal cancer. We retrospectively studied 7 patients who underwent pericardiocentesis with intrapericardial cisplatin instillation for malignant pericardial effusion resulting from esophageal cancer. After pericardiocentesis, we performed catheterization of the pericardial space under ultrasonogram guidance. Malignant etiology of the pericardial fluid was confirmed by cytological examination. Subsequently, cisplatin (10 mg in 20 mL normal saline) was instilled into the pericardial space. The mean total volume of the aspirated effusion fluid was 782 +/- 264 mL (range, 400-1200 mL). The drainage catheter was successfully removed in all patients, and the mean duration of pericardial drainage was 7.7 +/- 2.7 d (range, 5-13 d). No fluid reaccumulation was observed. Mean survival time was 120 +/- 71 d (range, 68-268 d). Pericardiocentesis along with catheter drainage appears to be a safe and effective for pericardial malignant effusion and tamponade, and cisplatin instillation prevents recurrence.