Samsung Medical Center : Early-Stage Cancer After Stent Procedure: Surgery Within One Month Reduces Recurrence Risk

Even if a patient has undergone coronary artery stent placement, a new study shows that undergoing cancer surgery within one month can lower the risk of recurrence — if the cancer is in an early stage and bleeding can be managed.

Traditionally, surgery has been delayed for at least 6 months to a year after a coronary stent procedure due to bleeding risks. However, this study suggests that, under the right conditions, earlier surgery may be preferable.

A research team at Samsung Medical Center — including Professors Kim Hong-kwan and Lee Jung-hee from the Department of Thoracic and Esophageal Surgery, Professor Choi Ki-hong from the Division of Cardiology, and Professor Kang Dan-bi from the Center for Clinical Epidemiology — recently published their findings in the Journal of the American Heart Association, analyzing outcomes based on the timing of cancer surgery following a stent procedure.

The team reviewed 3,621 patients who underwent cancer surgery within one year of stent implantation from 2008 to 2018. Patients who received surgery within one month of diagnosis showed a 30% lower recurrence rate compared to those who had delayed surgery.

Even within one year of stenting, if the cancer is in an early stage and bleeding risks are controllable, early surgery appears to significantly help reduce the risk of recurrence before the cancer progresses.

The average time from stenting to surgery was 5 months — earlier than the 6-month guideline — yet the study found no significant increase in cardiovascular complications such as bleeding or myocardial infarction.

Nevertheless, the researchers stressed the importance of a multidisciplinary approach to carefully identify patients eligible for early surgery. The study also revealed that surgeries performed within 6 months of stenting had a 24% higher risk of bleeding and a 112% higher risk of myocardial infarction. Even surgeries within 12 months carried higher risks compared to later surgeries.

Professor Kang Dan-bi noted, “This is a nationwide study based on Korea’s National Health Insurance Service big data, and its clinical implications are significant. Given that most coronary intervention patients are elderly, we need strategies to lessen the burden of cancer.”

Professor Kim Hong-kwan emphasized, “Delaying cancer surgery may result in progression of the disease, making surgery impossible or worsening the prognosis. A patient-centered approach is essential to balance cancer treatment efficacy with cardiovascular safety. Collaboration among internal medicine, surgery, and hemato-oncology teams is crucial to determine the optimal timing for surgery.”