Comparison of different series can be difficult because there is so much variation in prognosis depending on the cell type of the primary and on the stage of the tumor as well as the general health of the patients. Certain generalizations can be made. Untreated patients usually die within 2 weeks. Patients treated with pericardiocentesis alone can have long term palliation, but rapid reaccumulation of fluid and recurrence of tamponade is the usual course of events. Patients with malignant pericardial effusion usually die within one year of diagnosis, with the one exception of malignant lymphoma where patients can live for many years with effective chemotherapy.
Lung cancer carries a much shorter survival than does breast cancer.
Cannulation of the pericardium by pericardiocentesis and Seldinger technique with drainage and later sclerosis with tetracycline or treatment with antineoplastic agents has recieved increasing interest over the past few years and is felt to be the best treatment in some review articles. It has the disadvantages that it carries the risk of pericardiocentesis, is painful for the patient and can result in recurrence. Surgical resection of pericardium can provide reasonable palliation by removal of the threat of tamponade. Recurrence can occur when only a pericardial window is performed, presumably when fibrosis causes closure of the window. We have seen pericardial constriction develop secondary to tumor growth months after a pericardial window resection.