Year 2014 Vol. 22 No 5

ONCOLOGY

U.U. ANDRUSHCHUK 1, Y.P. OSTROVSKY 1, V.V. ZHARKOV 2, S.A. KURGANOVICH 1, T.T. GEVORKYAN 1, V.E. PONOMAREVA 2, M.M. SHASHURO 2, N.M. NOVITSKAJA 1

THE COMPARATIVE ANALYSIS OF SURGICAL TREATMENT OF PATIENTS WITH TUMORS OF THE MAIN LOCATIONS AND COMPETITIVE CORONARY HEART DISEASE WITH DRUG THERAPY AND AFTER THE PRELIMINARY MYOCARDIAL REVASCULARIZATION

SE Republican Scientific Practical Center Cardiology, 1 Minsk,
SE N.N. Alexandrov Republican Scientific Practical Center of Oncology and Medical Radiology 2, Minsk,
The Republic of Belarus

Objectives. To assess a comparative analysis of the immediate results of radical surgical treatment of patients with tumors of the main locations and competing coronary heart disease (CHD) with drug therapy and after the preliminary myocardial revascularization on the basis of the designed algorithm.
Methods. The patients (n=238) have been radically operated on for tumors of the main locations accompanied by cardiotropic therapy (1st group) and 13 patients after myocardial revascularization surgery (2nd group). Patients of the first group were reliably older, but with a less pronounced cardiac pathology. The average functional class of heart failure and angina pectoris in patients of the second group was found to be significantly higher. There was no difference in the groups by gender, body mass index, type of oncological surgery.
Results. The duration of the operations amounted to 150,84,63 min. vs 331,335,6 min. for the first and second groups, respectively (p<0,005). The incidence of major cardiac complications was 10,1% and 0%, respectively (p=0,37), non-cardiac 7,6% and 15,4% (p=0,65), all major postoperative complications 16,8% and 15,4% (p=0,72), in-hospital mortality 3,4% and 7,7% (p=0,50), average length of a hospital stay 21,50,61 and 24,31,90 (p=0,19). Cardiac pathology itself was not considered to be as the main reason of the 9 (3,6%) deaths within the hospital period in both groups, but in 2 cases of the first group (0,8%) it exacerbated the complicated course of early postoperative period.
Conclusion. There were no significant differences in the proportion of major cardiac, non-cardiac, major postoperative complications, hospital mortality, duration of hospitalization of patients after radical surgery for tumor of the main locations with competitive CHD operated with drug therapy or after preliminary myocardial revascularization according to the worked out algorithm.

Keywords: cancer, coronary heart disease, aortic coronary shunting
p. 589-595 of the original issue
References
  1. Van der Pijl LL, Birim O, van Gameren M, Kappetein AP, Maat AP, Steyerberg EW, Bogers AJ. Validation of a prognostic model to predict survival after non-small-cell lung cancer surgery. Eur J Cardiothorac Surg. 2010 Nov;38(5):6159.
  2. ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: A Report of the American College of Cardiology. J Am Coll Cardiol. 2007;50(17):e159-e242.
  3. Guidelines: Pre-operative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-Cardiac Surgery. Eur Heart J. 2009;30(22):276912.
  4. Ostrovskii IuP, Zharkov VV, Andrushchuk VV, Shestakova ShG, Mal'kevich VT, Iasko PG, Baranov AIu. Simul'tannoe khirurgicheskoe lechenie zlokachestvennykh novoobrazovanii razlichnykh lokalizatsii i konkuriruiushchei ishemicheskoi bolezni serdtsa - novyi podkhod [Simultaneous surgical treatment of malignant tumors of different localization and competing coronary heart disease - a new approach]. Belorus Med Zhurn. 2006;(2):7071.
  5. Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, Hochman JS, Krumholz HM, Kushner FG, Lamas GA, Mullany CJ, Ornato JP, Pearle DL, Sloan MA, Smith SC Jr, Alpert JS, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Gregoratos G, Halperin JL, Hiratzka LF, Hunt SA, Jacobs AK; ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction - executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). Circulation. 2004 Aug 3;110(5):58836.
  6. Fox K, Garcia MA, Ardissino D, Buszman P, Camici PG, Crea F, Daly C, De Backer G, Hjemdahl P, Lopez-Sendon J, Marco J, Morais J, Pepper J, Sechtem U, Simoons M, Thygesen K, Priori SG, Blanc JJ, Budaj A, Camm J, Dean V, Deckers J, Dickstein K, Lekakis J, McGregor K, Metra M, Morais J, Osterspey A, Tamargo J, Zamorano JL. Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. Eur Heart J. 2006 Jun;27(11):134181
  7. Bassand JP, Hamm CW, Ardissino D, Boersma E, Budaj A, Fernandez-Aviles F, Fox KA, Hasdai D, Ohman EM, Wallentin L, Wijns W. Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes. Eur Heart J. 2007 Jul;28(13):1598660.
  8. Silber S, Albertsson P, Aviles FF, Camici PG, Colombo A, Hamm C, Jorgensen E, Marco J, Nordrehaug JE, Ruzyllo W, Urban P, Stone GW, Wijns W. Guidelines for percutaneous coronary interventions. The Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology. Eur Heart J. 2005 Apr;26(8):80447.
  9. Van de Werf F, Bax J, Betriu A, Blomstrom-Lundqvist C, Crea F, Falk V, Filippatos G, Fox K, Huber K, Kastrati A, Rosengren A, Steg PG, Tubaro M, Verheugt F, Weidinger F, Weis M. Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation: the Task Force on the Management of ST-Segment Elevation Acute Myocardial Infarction of the European Society of Cardiology. Eur Heart J. 2008 Dec;29(23):290945.
  10. Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM, Grunwald MA, Levy D, Lytle BW, O'Rourke RA, Schafer WP, Williams SV, Ritchie JL, Cheitlin MD, Eagle KA, Gardner TJ, Garson A Jr, Russell RO, Ryan TJ, Smith SC Jr. ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology. J Am Coll Cardiol. 1999 Jun;33(7):2092197.
  11. Hunt SA. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology. J Am Coll Cardiol. 2005 Sep 20;46(6):e182.
Address for correspondence:
220036, Respublika Belarus',
g. Minsk, ul. R.Liuksemburg,
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nauchno-prakticheskii tsentr Kardiologiia,
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rab. +375 17 2088605,
e-mail: heartslight@mail.ru,
Andrushchuk Vladimir Vladimirovich
Information about the authors:
Andruschuk VV, MD, a cardiac surgeon of the 2nd cardiac surgery department of the State Institution "Republican Scientific and Practical Centre Cardiology", the Laboratory of Cardiac Surgery.
Zharkov VV, MD, professor, a csenior researcher of the Department of Thoracic Anesthesiology oncopathology with a group of anestesiology of SE "Republican Scientific and Practical Centre of Oncology and Medical Radiology named by N.N. Aleksandrov. "
Ostrovsky YP, MD, professor, a corresponding member of the National Academy of Sciences, a head of the chair of Cardiac Surgery GUO "Belarusian Medical Academy of Postgraduate Education," the chief cardiac surgeon freelance of Ministry of Health of the Republic of Belarus.
Mounds SA, a specialist-physician of ultrasonic diagnostics SI "Republican Scientific and Practical Centre Cardiology", of the laboratory of cardiac surgery.
Gevorgyan TT, a specialist department of functional diagnostics SI "Republican Scientific and Practical Centre Cardiology".
Ponomareva VE, a physician of SI "Republican Scientific and Practical Centre of Oncology and Medical Radiology named by N.N. Aleksandrov" .
Shashuro MM, an assistant of department of thoracic cancer pathology with a group of anesthesiology GU "Republican Scientific and Practical Center of Oncology and Medical Radiology named by N.N. Aleksandrov".
Nowicka NM, an assistant of heart surgery laboratory SI "Republican Scientific and Practical Centre Cardiology ".
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