消化系统肿瘤心脏转移的临床特征分析

Clinical characteristics of digestive system cancers metastatic to the heart

目的探讨消化系统肿瘤心脏转移的临床特征,为临床实践提供参考。方法回顾性分析1999年1月至2021年1月中国医学科学院肿瘤医院收治的19例消化系统肿瘤心脏转移患者的临床资料和生存资料,生存分析采用Kaplan-Meier法。结果19例患者中,原发肿瘤为食管鳞癌7例,胃或胃食管结合部腺癌6例,肝癌3例,肠癌3例;心包转移16例,右心房转移2例,左心室转移1例。最常见的症状为胸闷气短(8例)。诊断心脏转移后,7例患者接受了局部治疗,11例患者接受了全身治疗。患者自诊断消化系统肿瘤开始的中位总生存时间为31.4个月,自诊断心脏转移的中位生存时间为4.7个月。结论消化系统肿瘤心脏转移发生率低,预后不佳。系统性药物治疗是消化系统肿瘤心脏转移治疗的基础,新的抗肿瘤药物可能有助于提高疗效。

Objective To investigate the clinical features of patients with cardiac metastases from digestive system tumors.Methods This retrospective study collected and analyzed the medical records of patients with cardiac metastases from digestive system tumors who received treatments in the Cancer Hospital,Chinese Academy of Medical Sciences between January 1999 and January 2021.Kaplan-Meier method was used for survival analysis.Results A total of 19 patients were identified.The primary tumors were esophageal squamous cell carcinoma(n=7),gastric or gastroesophageal junction adenocarcinoma(n=6),hepatobiliary cancers(n=3)and colorectal cancers(n=3).16 patients had pericardial metastases,2 patients had right atrium metastases,and 1 patient had left ventricle metastasis.The most common symptom was dyspnea,which was present in 8 cases.7 patients received locoregional treatment,while 11 patients underwent systemic therapies.The median overall survival from diagnosis of primary cancer was 31.4 months,and the median overall survival time from diagnosis of cardiac metastasis was 4.7 months.Conclusion Cardiac metastasis from digestive system tumors is associated with low incidence and a poor prognosis.Systemic treatment remains the cornerstone of management,while novel anti-tumor drugs may improve therapeutic efficacy.