Outcomes After Surgical Resection of Primary Non-Myxoma Cardiac Tumors

Abstract

ObjectivePrimary cardiac tumors are rare lesions with different histological type. We reviewed our 17 years of experience in the surgical treatment and clinical results of primary non-myxoma cardiac tumors.MethodsBetween July 2000 and February 2017, 21 patients with primary cardiac tumor were surgically treated in our institution. The tumors were categorized as benign non-myxomas and malignants. Data including the demographic characteristics, details of the tumor histology and grading, cardiac medical and surgical history, surgical procedure of the patients were obtained from the hospital database.ResultsEleven patients were diagnosed with benign non-myxoma tumor (male/female:7/4), ranging in age from 10 days to 74 years (mean age 30.9±26.5 years). Papillary fibroelastoma was the most frequent type (63.6%). There were two early deaths in benign group (all were rhabdomyoma), and mortality rate was 18%. The mean follow-up period was 69.3±58.7 months (range, 3 to 178 months). All survivals in benign group were free of tumor-related symptoms and tumor relapses. Ten patients were diagnosed with malignant tumor (sarcoma/lymphoma:8/2, male/female:3/7), ranging in age from 14 years to 73 years (mean age 44.7±18.9 years). Total resection could be done in only three (30%) patients. The mean follow-up period was 18.7±24.8 months (range, 0-78 months). Six patients died in the first 10 months.ConclusionComplete resection of the cardiac tumors, whenever possible, is the main goal of surgery. Surgical resection of benign cardiac tumors is safe, usually curative and provides excellent long-term prognosis. On the contrary, malignant cardiac tumors still remain highly lethal.

Nomograms and risk classification systems predicting overall and cancer‐specific survival in primary malignant cardiac tumor

“…We found that the tumor stage was an independent prognostic factor for both OS and CSS in PMCTs, which is consistent with the previous studies that tumor stage had a prognostic association with OS in PMCTs. We also identified cancer‐directed surgery as an independent prognostic factor for OS and CSS in PMCTs, which concurred with the Mayo Clinic experience that surgical excision of primary cardiac tumors was associated with better survival and a complete resection should be performed if possible …”

“…We also identified cancer-directed surgery as an independent prognostic factor for OS and CSS in PMCTs, which concurred with the Mayo Clinic experience that surgical excision of primary cardiac tumors was associated with better survival 28 and a complete resection should be performed if possible. 9,29 We also identified chemotherapy as an independent prognostic factor for OS and CSS in PMCTs. Previous reports 14,25 believed that chemotherapy was a preferred primary treatment modality for primary cardiac lymphoma patients because of the sensitivity of lymphoma to chemotherapy, and chemotherapy might prolong OS in primary cardiac sarcomas but it was not confirmed.…”

Cerebral embolization associated with parenchymal seeding of the left atrial myxoma: Potential role of interleukin‐6 and matrix metalloproteinases

“…7,8 As 75-80% of the tumors arise in the left atrium, approximately half of the embolic events may affect the central nervous system (CNS). 9 The neurological manifestation of cerebral embolization depends on whether embolic tumor cells remain intraluminal, leading to ischemic stroke, invade the vessel wall, resulting in intracranial aneurysms, or, in rare circumstances, transgress the vessel wall, leading to brain parenchymal seeding. 10 Factors related to the intracranial dissemination of left cardiac myxomas remain unidentified.…”

Development and validation of a nomogram prediction model for early mortality in patients with primary malignant cardiac tumors

“…Although PMCT patients have a dismal prognosis, our study confirms surgical resection and chemotherapy are associated with a favourable early prognosis. In one study, clinical experience suggested cancer-directed surgical excision was associated with better survival in PMCTs patients (26)(27)(28). Surgery intervention is mostly performed in those at an advanced tumor stage, as without it PMCTs can cause hemodynamics disorder, heart failure, hemorrhagic pericardial effusion, and supra-ventricular arrhythmia in a short time.…”