Background/Objectives: Cancer survivors can develop heart conditions such as aortic valve disease because of age and other shared risk factors. If this valve condition becomes symptomatic, the prognosis is poor if the valve is not replaced. Surgical aortic valve replacement (SAVR) is one mode of treatment. Methods: Of 2500 consecutive patients who underwent SAVR with a biological valve, 388 patients were cancer survivors. They were compared for preoperative characteristics, operative parameters, postoperative adverse events, need for resources, and long-term survival. For the latter, the six most common tumors (prostate, breast, colorectal, bladder, pulmonary, and hematologic) and the effect of the interval between cancer treatment and cardiac surgery were scrutinized. Results: Cancer increased significantly over time. Pulmonary and kidney disease differed between the groups, but cardiac comorbid conditions did not. Operative parameters, early adverse events, and need for resources did not differ. Median survival time was significantly reduced in cancer survivors: 104 (97–112) versus 119 (116–122) months, and this was driven by an interval of less than 5 years and prior lung cancer. Prior cancer was the least important of ten predictors for long-term mortality. Conclusions: The outcome of cancer survivors after SAVR is acceptable. For patients with pulmonary cancer, the outcome is poor.
背景/目的：癌症幸存者可能因年龄及其他共同风险因素而罹患主动脉瓣疾病等心脏问题。若该瓣膜病变出现症状且未进行瓣膜置换，预后通常较差。外科主动脉瓣置换术（SAVR）是治疗方式之一。方法：在连续接受生物瓣膜SAVR的2500例患者中，388例为癌症幸存者。研究比较了这些患者的术前特征、手术参数、术后不良事件、资源需求及长期生存情况。针对长期生存，重点分析了六种最常见肿瘤（前列腺癌、乳腺癌、结直肠癌、膀胱癌、肺癌及血液系统肿瘤）以及癌症治疗与心脏手术间隔时长的影响。结果：癌症发病率随时间显著上升。两组间肺部与肾脏疾病存在差异，但心脏合并症无显著区别。手术参数、早期不良事件及资源需求均无差异。癌症幸存者的中位生存期显著缩短：104（97-112）个月对比119（116-122）个月，其主要影响因素为癌症治疗与心脏手术间隔时间少于5年以及既往肺癌病史。在长期死亡率的十大预测因子中，既往癌症史的影响程度最低。结论：癌症幸存者接受SAVR后的预后总体可接受，但既往肺癌患者的预后较差。
肿瘤(癌症)患者之家