Progress of surgical treatment in patients with coronary artery disease combined with malignancy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Yiding ^1,2 ,  WANG Jin ¹ , LI Fei ¹

1. Department of Cardiac Surgery, Peking University First Hospital, Beijing, 100034, P. R. China;
2. Department of Cardiovascular Surgery, The First Affiliated Hospital of Xinxiang Medical College, Xinxiang, 453100, Henan, P. R. China;

Corresponding author：

WANG Jin, Email: wj0463@sina.cn

Keywords：

Coronary artery disease; coronary artery bypass grafting; tumor resection; simultaneous surgery; review

DOI：

10.7507/1007-4848.202202037

Video：

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The treatment of patients suffering from both severe coronary artery disease (CAD) and malignancy is different from those who have isolated CAD or tumor, because their body condition is poorer and the lesions of coronary artery are severer, which poses severe challenges to doctors. At present, the surgical treatment for these patients mainly includes staged operation and simultaneous surgery. Staged operation, which separates coronary artery revascularization surgery from tumor resection, has a lower incidence of postoperative complications, but tumor progression may occur during the waiting period. Simultaneous surgery combines heart procedure with tumor resection at the same time, shortens the treatment period of patients, overcomes the defect of tumor progression that may occur during the waiting period of the staged surgery, but the incidence of postoperative complications is higher. The progress of surgical treatment in patients with CAD combined with malignant tumor is summarized.

Citation： ZHANG Yiding, WANG Jin, LI Fei. Progress of surgical treatment in patients with coronary artery disease combined with malignancy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(11): 1651-1655. doi: 10.7507/1007-4848.202202037 Copy

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2.	Curigliano G, Cardinale D, Dent S, et al. Cardiotoxicity of anticancer treatments: Epidemiology, detection, and management. CA Cancer J Clin, 2016, 66(4): 309-325.
3.	Suzuki M, Tomoike H, Sumiyoshi T, et al. Incidence of cancers in patients with atherosclerotic cardiovascular diseases. Int J Cardiol Heart Vasc, 2017, 17: 11-16.
4.	Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS guidelines on myocardial revascularization. EuroIntervention, 2019, 14(14): 1435-1534.
5.	Guha A, Dey AK, Kalra A, et al. Coronary artery bypass grafting in cancer patients: Prevalence and outcomes in the United States. Mayo Clin Proc, 2020, 95(9): 1865-1876.
6.	Kamiike W, Miyata M, Izukura M, et al. Simultaneous surgery for coronary artery disease and gastric cancer. World J Surg, 1994, 18(6): 879-881.
7.	Miller DL, Orszulak TA, Pairolero PC, et al. Combined operation for lung cancer and cardiac disease. Ann Thorac Surg, 1994, 58(4): 989-993.
8.	Voets AJ, Joesoef KS, van Teeffelen ME. Synchroneously occurring lung cancer (stagesⅠ-Ⅱ) and coronary artery disease: Concomitant versus staged surgical approach. Eur J Cardiothorac Surg, 1997, 12(5): 713-717.
9.	Ozsöyler I, Yilik L, Bozok S, et al. Off-pump coronary artery bypass surgery in patients with coronary artery disease and malign neoplasia: Results of ten patients and review of the literature. Heart Vessels, 2006, 21(6): 365-367.
10.	Nurözler F, Kutlu ST, Kücük G. Off-pump coronary bypass for patients with concomitant malignancy. Circ J, 2006, 70(8): 1048-1051.
11.	Darwazah AK, Osman M, Sharabati B. Use of off-pump coronary artery bypass surgery among patients with malignant disease. J Card Surg, 2010, 25(1): 1-4.
12.	Suzuki S, Usui A, Yoshida K, et al. Effect of cardiopulmonary bypass on cancer prognosis. Asian Cardiovasc Thorac Ann, 2010, 18(6): 536-540.
13.	Hirose H, Amano A, Yoshida S, et al. Coronary artery bypass grafting in patient with malignant neoplasm. Efficacy of coronary artery bypass grafting on beating heart. Jpn J Thorac Cardiovasc Surg, 2000, 48(2): 96-100.
14.	Dalton ML, Parker TM, Mistrot JJ, et al. Concomitant coronary artery bypass and major noncardiac surgery. J Thorac Cardiovasc Surg, 1978, 75(4): 621-624.
15.	Piehler JM, Trastek VF, Pairolero PC, et al. Concomitant cardiac and pulmonary operations. J Thorac Cardiovasc Surg, 1985, 90(5): 662-667.
16.	Rosalion A, Woodford NW, Clarke CP, et al. Concomitant coronary revascularization and resection of lung cancer. Aust N Z J Surg, 1993, 63(5): 336-340.
17.	Yokoyama T, Derrick MJ, Lee AW. Cardiac operation with associated pulmonary resection. J Thorac Cardiovasc Surg, 1993, 105(5): 912-916.
18.	Terzi A, Furlan G, Magnanelli G, et al. Lung resections concomitant to coronary artery bypass grafting. Eur J Cardiothorac Surg, 1994, 8(11): 580-584.
19.	Dyszkiewicz W, Jemielity MM, Piwkowski CT, et al. Simultaneous lung resection for cancer and myocardial revascularization without cardiopulmonary bypass (off-pump coronary artery bypass grafting). Ann Thorac Surg, 2004, 77(3): 1023-1027.
20.	马旭晨, 张志泰, 区颂雷, 等. 肺部肿瘤合并冠心病同期手术治疗经验. 中华医学杂志, 2007, 87(25): 1758-1760.
21.	Schoenmakers MC, van Boven WJ, van den Bosch J, et al. Comparison of on-pump or off-pump coronary artery revascularization with lung resection. Ann Thorac Surg, 2007, 84(2): 504-509.
22.	Dyszkiewicz W, Jemielity M, Piwkowski C, et al. The early and late results of combined off-pump coronary artery bypass grafting and pulmonary resection in patients with concomitant lung cancer and unstable coronary heart disease. Eur J Cardiothorac Surg, 2008, 34(3): 531-535.
23.	马旭晨, 区颂雷, 张志泰, 等. 肺切除联合非体外循环冠状动脉旁路移植同期手术治疗经验. 中华医学杂志, 2012, 92(44): 3134-3136.
24.	Yang Y, Xiao F, Wang J, et al. Simultaneous surgery in patients with both cardiac and noncardiac diseases. Patient Prefer Adher, 2016, 10: 1251-1258.
25.	Liu B, Chen C, Gu C, et al. Combined coronary artery bypass graft (CABG) surgery and lung resection for lung cancer in patients more than 50 years-of-age. Med Sci Monit, 2018, 24: 3307-3314.
26.	Cao Z, Huang H, Zhou Y, et al. Efficacy of on-pump coronary artery bypass grafting and stent implantation combined with surgery on lung cancer. J BUON, 2019, 24(6): 2253-2259.
27.	Li Z, Liu B, Ge W, et al. Effect of simultaneous surgical treatment of severe coronary artery disease and lung cancer. J Int Med Res, 2019, 47(2): 591-599.
28.	Porkhanov VA, Belash SA, Polyakov IS, et al. Simultaneous surgery for concomitant lung cancer and diffuse coronary atherosclerosis. Khirurgiia (Mosk), 2021, (3): 42-49.
29.	Wang Z, Guo F, Li J, et al. Safety and efficacy of lobectomy combined with off-pump coronary artery bypass grafting for lung cancer. J Thorac Dis, 2021, 13(7): 4438-4447.
30.	杨阳, 肖锋, 王进, 等. 同期手术治疗心脏病和非心脏疾病. 北京大学学报(医学版), 2021, 53(2): 327-331.
31.	Takahashi T, Nakano S, Shimazaki Y, et al. Concomitant coronary bypass grafting and curative surgery for cancer. Surg Today, 1995, 25(2): 131-135.
32.	Komokata T, Fukueda M, Kaieda M, et al. Simultaneous operation for cardiac disease and gastrointestinal malignancy. World J Gastrointest Surg, 2014, 6(8): 146-150.
33.	Liu B, Gu C, Wang Y, et al. Feasibility and efficacy of simultaneous off-pump coronary artery bypass grafting and esophagectomy in elderly patients. Oncotarget, 2017, 8(28): 46498-46505.
34.	Zhang W, Liu B, Zhou Y, et al. Combined surgical treatment of esophageal cancer and coronary heart diseases in elderly patients. World J Surg Oncol, 2018, 16(1): 213.
35.	杨阳, 肖锋, 王进, 等. 肿瘤合并冠心病患者的同期外科治疗. 北京大学学报(医学版), 2007, 39(4): 416-419.
36.	Zhang H, Wang DX, Xiao F, et al. The impact of previous or concomitant myocardium revascularization on the outcomes of patients undergoing major non-cardiac surgery. Interact Cardiovasc Thorac Surg, 2009, 9(5): 788-792.
37.	Yeginsu A, Vayvada M, Karademir BC, et al. Combined off-pump coronary artery bypass grafting and lung resection in patients with lung cancer accompanied by coronary artery disease. Braz J Cardiovasc Surg, 2018, 33(5): 483-489.
38.	马旭晨, 张志泰, 胡燕生, 等. 肺癌合并严重冠心病同期外科手术治疗经验. 中国肺癌杂志, 2012, 15(10): 602-605.
39.	Ma X, Huang F, Zhang Z, et al. Lung cancer resection with concurrent off-pump coronary artery bypasses: Safety and efficiency. J Thorac Dis, 2016, 8(8): 2038-2045.
40.	Ding CZ, Wang GL, Wang HT, et al. Esophagectomy combined with off-pump coronary artery bypass grafting through left posterolateral incision is safe and feasible for esophageal cancer associated with coronary artery disease. Dis Esophagus, 2021, 34(10): doaa123.
41.	Zhao J, Han Y, Lei J, et al. Simultaneous esophagectomy and off-pump coronary artery bypass grafting: A practicable approach with good survival. Dis Esophagus, 2017, 30(1): 1-5.
42.	张毅, 魏翔, 潘铁成. 非小细胞肺癌外科治疗联合同期非体外循环冠状动脉旁路移植术. 中国肺癌杂志, 2009, 12(4): 332-336.
43.	Boersma E, Kertai MD, Schouten O, et al. Perioperative cardiovascular mortality in noncardiac surgery: Validation of the Lee cardiac risk index. Am J Med, 2005, 118(10): 1134-1141.
44.	董士勇, 王进, 张思宇, 等. 非体外循环冠状动脉旁路移植术联合中度以上创伤非心脏手术的围手术期安全性研究及可行性评价. 中华外科杂志, 2021, 59(1): 46-51.

1. GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2018, 392(10159): 1736-1788.
2. Curigliano G, Cardinale D, Dent S, et al. Cardiotoxicity of anticancer treatments: Epidemiology, detection, and management. CA Cancer J Clin, 2016, 66(4): 309-325.
3. Suzuki M, Tomoike H, Sumiyoshi T, et al. Incidence of cancers in patients with atherosclerotic cardiovascular diseases. Int J Cardiol Heart Vasc, 2017, 17: 11-16.
4. Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS guidelines on myocardial revascularization. EuroIntervention, 2019, 14(14): 1435-1534.
5. Guha A, Dey AK, Kalra A, et al. Coronary artery bypass grafting in cancer patients: Prevalence and outcomes in the United States. Mayo Clin Proc, 2020, 95(9): 1865-1876.
6. Kamiike W, Miyata M, Izukura M, et al. Simultaneous surgery for coronary artery disease and gastric cancer. World J Surg, 1994, 18(6): 879-881.
7. Miller DL, Orszulak TA, Pairolero PC, et al. Combined operation for lung cancer and cardiac disease. Ann Thorac Surg, 1994, 58(4): 989-993.
8. Voets AJ, Joesoef KS, van Teeffelen ME. Synchroneously occurring lung cancer (stagesⅠ-Ⅱ) and coronary artery disease: Concomitant versus staged surgical approach. Eur J Cardiothorac Surg, 1997, 12(5): 713-717.
9. Ozsöyler I, Yilik L, Bozok S, et al. Off-pump coronary artery bypass surgery in patients with coronary artery disease and malign neoplasia: Results of ten patients and review of the literature. Heart Vessels, 2006, 21(6): 365-367.
10. Nurözler F, Kutlu ST, Kücük G. Off-pump coronary bypass for patients with concomitant malignancy. Circ J, 2006, 70(8): 1048-1051.
11. Darwazah AK, Osman M, Sharabati B. Use of off-pump coronary artery bypass surgery among patients with malignant disease. J Card Surg, 2010, 25(1): 1-4.
12. Suzuki S, Usui A, Yoshida K, et al. Effect of cardiopulmonary bypass on cancer prognosis. Asian Cardiovasc Thorac Ann, 2010, 18(6): 536-540.
13. Hirose H, Amano A, Yoshida S, et al. Coronary artery bypass grafting in patient with malignant neoplasm. Efficacy of coronary artery bypass grafting on beating heart. Jpn J Thorac Cardiovasc Surg, 2000, 48(2): 96-100.
14. Dalton ML, Parker TM, Mistrot JJ, et al. Concomitant coronary artery bypass and major noncardiac surgery. J Thorac Cardiovasc Surg, 1978, 75(4): 621-624.
15. Piehler JM, Trastek VF, Pairolero PC, et al. Concomitant cardiac and pulmonary operations. J Thorac Cardiovasc Surg, 1985, 90(5): 662-667.
16. Rosalion A, Woodford NW, Clarke CP, et al. Concomitant coronary revascularization and resection of lung cancer. Aust N Z J Surg, 1993, 63(5): 336-340.
17. Yokoyama T, Derrick MJ, Lee AW. Cardiac operation with associated pulmonary resection. J Thorac Cardiovasc Surg, 1993, 105(5): 912-916.
18. Terzi A, Furlan G, Magnanelli G, et al. Lung resections concomitant to coronary artery bypass grafting. Eur J Cardiothorac Surg, 1994, 8(11): 580-584.
19. Dyszkiewicz W, Jemielity MM, Piwkowski CT, et al. Simultaneous lung resection for cancer and myocardial revascularization without cardiopulmonary bypass (off-pump coronary artery bypass grafting). Ann Thorac Surg, 2004, 77(3): 1023-1027.
20. 马旭晨, 张志泰, 区颂雷, 等. 肺部肿瘤合并冠心病同期手术治疗经验. 中华医学杂志, 2007, 87(25): 1758-1760.
21. Schoenmakers MC, van Boven WJ, van den Bosch J, et al. Comparison of on-pump or off-pump coronary artery revascularization with lung resection. Ann Thorac Surg, 2007, 84(2): 504-509.
22. Dyszkiewicz W, Jemielity M, Piwkowski C, et al. The early and late results of combined off-pump coronary artery bypass grafting and pulmonary resection in patients with concomitant lung cancer and unstable coronary heart disease. Eur J Cardiothorac Surg, 2008, 34(3): 531-535.
23. 马旭晨, 区颂雷, 张志泰, 等. 肺切除联合非体外循环冠状动脉旁路移植同期手术治疗经验. 中华医学杂志, 2012, 92(44): 3134-3136.
24. Yang Y, Xiao F, Wang J, et al. Simultaneous surgery in patients with both cardiac and noncardiac diseases. Patient Prefer Adher, 2016, 10: 1251-1258.
25. Liu B, Chen C, Gu C, et al. Combined coronary artery bypass graft (CABG) surgery and lung resection for lung cancer in patients more than 50 years-of-age. Med Sci Monit, 2018, 24: 3307-3314.
26. Cao Z, Huang H, Zhou Y, et al. Efficacy of on-pump coronary artery bypass grafting and stent implantation combined with surgery on lung cancer. J BUON, 2019, 24(6): 2253-2259.
27. Li Z, Liu B, Ge W, et al. Effect of simultaneous surgical treatment of severe coronary artery disease and lung cancer. J Int Med Res, 2019, 47(2): 591-599.
28. Porkhanov VA, Belash SA, Polyakov IS, et al. Simultaneous surgery for concomitant lung cancer and diffuse coronary atherosclerosis. Khirurgiia (Mosk), 2021, (3): 42-49.
29. Wang Z, Guo F, Li J, et al. Safety and efficacy of lobectomy combined with off-pump coronary artery bypass grafting for lung cancer. J Thorac Dis, 2021, 13(7): 4438-4447.
30. 杨阳, 肖锋, 王进, 等. 同期手术治疗心脏病和非心脏疾病. 北京大学学报(医学版), 2021, 53(2): 327-331.
31. Takahashi T, Nakano S, Shimazaki Y, et al. Concomitant coronary bypass grafting and curative surgery for cancer. Surg Today, 1995, 25(2): 131-135.
32. Komokata T, Fukueda M, Kaieda M, et al. Simultaneous operation for cardiac disease and gastrointestinal malignancy. World J Gastrointest Surg, 2014, 6(8): 146-150.
33. Liu B, Gu C, Wang Y, et al. Feasibility and efficacy of simultaneous off-pump coronary artery bypass grafting and esophagectomy in elderly patients. Oncotarget, 2017, 8(28): 46498-46505.
34. Zhang W, Liu B, Zhou Y, et al. Combined surgical treatment of esophageal cancer and coronary heart diseases in elderly patients. World J Surg Oncol, 2018, 16(1): 213.
35. 杨阳, 肖锋, 王进, 等. 肿瘤合并冠心病患者的同期外科治疗. 北京大学学报(医学版), 2007, 39(4): 416-419.
36. Zhang H, Wang DX, Xiao F, et al. The impact of previous or concomitant myocardium revascularization on the outcomes of patients undergoing major non-cardiac surgery. Interact Cardiovasc Thorac Surg, 2009, 9(5): 788-792.
37. Yeginsu A, Vayvada M, Karademir BC, et al. Combined off-pump coronary artery bypass grafting and lung resection in patients with lung cancer accompanied by coronary artery disease. Braz J Cardiovasc Surg, 2018, 33(5): 483-489.
38. 马旭晨, 张志泰, 胡燕生, 等. 肺癌合并严重冠心病同期外科手术治疗经验. 中国肺癌杂志, 2012, 15(10): 602-605.
39. Ma X, Huang F, Zhang Z, et al. Lung cancer resection with concurrent off-pump coronary artery bypasses: Safety and efficiency. J Thorac Dis, 2016, 8(8): 2038-2045.
40. Ding CZ, Wang GL, Wang HT, et al. Esophagectomy combined with off-pump coronary artery bypass grafting through left posterolateral incision is safe and feasible for esophageal cancer associated with coronary artery disease. Dis Esophagus, 2021, 34(10): doaa123.
41. Zhao J, Han Y, Lei J, et al. Simultaneous esophagectomy and off-pump coronary artery bypass grafting: A practicable approach with good survival. Dis Esophagus, 2017, 30(1): 1-5.
42. 张毅, 魏翔, 潘铁成. 非小细胞肺癌外科治疗联合同期非体外循环冠状动脉旁路移植术. 中国肺癌杂志, 2009, 12(4): 332-336.
43. Boersma E, Kertai MD, Schouten O, et al. Perioperative cardiovascular mortality in noncardiac surgery: Validation of the Lee cardiac risk index. Am J Med, 2005, 118(10): 1134-1141.
44. 董士勇, 王进, 张思宇, 等. 非体外循环冠状动脉旁路移植术联合中度以上创伤非心脏手术的围手术期安全性研究及可行性评价. 中华外科杂志, 2021, 59(1): 46-51.

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Progress of surgical treatment in patients with coronary artery disease combined with malignancy

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