학술논문
Clinical impact of perioperative atrial fibrillation on long-term recurrence of malignancy.
Document Type
Article
Author
Higuchi, Satoshi; Kabeya, Yusuke; Matsushita, Kenichi; Tachibana, Keisei; Kawachi, Riken; Takei, Hidefumi; Tanaka, Ryota; Suzuki, Yutaka; Imanishi, Yorihisa; Shibata, Shigeki; Hasegawa, Hiroshi; Saito, Koichiro; Moriyama, Kiyoshi; Yorozu, Tomoko; Abe, Nobutsugu; Kondo, Haruhiko; Matsuda, Takeaki; Yoshino, Hideaki
Source
Subject
*ATRIAL fibrillation
*SURGICAL complications
*CANCER relapse
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Language
ISSN
0910-8327
Abstract
Perioperative complications have been reported to be associated with a lower incidence of cancer-free survival. Perioperative atrial fibrillation (POAF) is one of occasionally observed complications in patients with malignancies who undergo noncardiac surgeries. However, the long-term clinical impact of POAF on those with malignancies have remained unknown. This was a prospective, single-center, observational study. Patients who underwent noncardiac surgeries for definitive malignancies between 2014 and 2017 were included. The primary and secondary endpoints were 3-year recurrence of malignancies and cancer death, respectively. The present study included consecutive 752 patients (mean age, 68 ± 11 years; males, 62%), and POAF was observed in 77 patients. The follow-up duration was 1037 (interquartile range, 699–1408) days. The 3-year recurrence of malignancies was observed in 239 (32%) patients (POAF, 32 [42%]; non-POAF, 207 [31%]) and 3-year mortality was 130 patients (17%). Cardiac, noncardiac, and cancer deaths were observed in 4 (0.5%), 126 (17%), and 111 (15%) patients, respectively. Multivariate Cox regression analysis demonstrated that POAF was associated with 3-year recurrence of malignancies (hazard ratio [HR], 1.70; 95% confidence interval [CI], 1.15–2.52). Landmark analysis demonstrated that POAF tended to be correlated with the incidence of 3-year cancer death (HR, 1.79; 95% CI, 0.96–3.31). In conclusion, POAF is associated with the subsequent recurrence of malignancies. The association of arrhythmia with cancer death may be revealed under longer follow-up durations. Clinical Trial Registration: https://upload.umin.ac.jp/cgi-open-bin/ctr%5fe/ctr%5fview.cgi?recptno=R000018270. UMIN ID: UMIN000016146. [ABSTRACT FROM AUTHOR]