CANCER after cardiac surgery was tied to shorter long-term survival, even though in-hospital mortality remained low.
Cancer After Cardiac Surgery and Long-Term Survival
As more patients present for cardiac surgery with active cancer or a prior cancer history, clinicians are increasingly balancing operative benefit with prognosis beyond discharge. In a retrospective comparison of 83 adults undergoing cardiac surgery, long-term outcomes were evaluated in patients with active cancer or a history of cancer versus those without cancer.
Patients were grouped as follows: 38 patients with active cancer or a history of cancer, and 45 patients without cancer. Demographic and perioperative variables were obtained from electronic records, and survival status was confirmed by telephone follow up with patients or relatives.
Survival Differences After Cardiac Surgery
In-hospital mortality was numerically higher among patients with cancer after cardiac surgery, though this difference did not reach statistical significance (5.3% versus 0.0%). The more notable divergence emerged over time. Mean survival was significantly shorter in the cancer group compared with patients without cancer, at 93.6 months versus 156.8 months.
Multivariable analysis identified cancer after cardiac surgery as an independent predictor of worse long-term survival (hazard ratio: 7.7). Two additional perioperative factors were also independently associated with poorer survival: hospitalisation longer than one week (hazard ratio: 4.2) and the need for fresh frozen plasma (hazard ratio: 7.0).
Clinical Implications for Perioperative Planning
The authors concluded that cardiac surgery can be performed with acceptable risk in patients with active cancer or a cancer history, but long-term survival is reduced, primarily attributed to cancer progression. These findings reinforce the value of a multidisciplinary approach when evaluating operative candidacy, aligning expected cardiac benefit with the likely cancer trajectory, and anticipating postoperative complexity.
Future research is needed to clarify which cancer and treatment characteristics most strongly shape outcomes after cardiac surgery, and to refine decision making for this growing patient population.
Reference: Aksoy T et al. Effect of cancer on long-term survival after cardiac surgery. Cardiovasc J Afr. 2025;36(3):255-260.
