Postoperative chemotherapy and radiation improve survival following cardiac sarcoma resection

Hendriksen, Brandon S.; Stahl, Kelly A.; Hollenbeak, Christopher S.; Taylor, Matthew D.; Vasekar, Monali; Conte, John V.; Soleimani, Behzad; Reed, Michael F.

doi:10.1016/j.jtcvs.2019.10.016

Cited by 28 publications

(36 citation statements)

References 25 publications

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“…The combination of Doxorubicin and Ifosfamide is the most widely adopted chemotherapy regimen. 12 , 13 The benefits of radiation therapy are even more controversial and can cause cardiac dysfunction. Despite this, the combination of surgery, chemo- and radiation-therapy has been reported with more than twice the median survival, if compared to surgery alone.…”

Section: Discussionmentioning

confidence: 99%

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Primary cardiac sarcoma: a case report of a therapeutic challenge

Andrei

Scheggi

Stefàno

et al. 2020

European Heart Journal - Case Reports

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Background Primary cardiac sarcomas are very rare and the prognosis is poor both because the diagnosis is typically made at an advanced stage of the disease and because data are insufficient to identify a standard treatment. Surgical resection is the cornerstone of therapy with the need to develop new therapeutic strategies. Case summary We present a case of a young man admitted to the emergency department due to worsening dyspnoea. A left-sided sarcoma was diagnosed and treated with surgery, chemo- and radiation therapy, and subsequently with heart transplant for local recurrence of the disease. Endomyocardial biopsy made during the routine follow-up period was complicated by pericardial tamponade and cardiogenic shock and the patient was managed with veno-arterial extracorporeal membrane oxygenation, until recovery of left ventricular function (left ventricular ejection fraction of 55%). After 1 year a kidney transplant was performed. After 42 months from diagnosis, the patient is in good general condition. Discussion Primary cardiac sarcomas are treated with surgery to reach R0 (free resection margins) and with chemo- and radiation therapy with adjuvant purposes. Auto-transplantation is also performed, while conventional heart transplant must be customized on an individual basis, after excluding metastases. A multidisciplinary assessment should be performed and the single patient treated with a personalized approach, in relation to his performance status, location of the mass, and stage of the disease.

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Section: Discussionmentioning

confidence: 99%

“…Despite this, the combination of surgery, chemo- and radiation-therapy has been reported with more than twice the median survival, if compared to surgery alone. 13 , 14 …”

Section: Discussionmentioning

confidence: 99%

Primary cardiac sarcoma: a case report of a therapeutic challenge

Andrei

Scheggi

Stefàno

et al. 2020

European Heart Journal - Case Reports

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“…Hendriksen et al demonstrated that median survival was more than 2-fold longer in patients after postoperative therapy compared with resection alone (19 vs. 8 months; p = 0.026). In addition, multivariate analysis showed a significant association between an improved survival rate and postoperative therapy (p = 0.009), although no significant difference in 5-year overall survival rates was observed [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, the current survival rate remains poor [ 4 , 5 ]. Postoperative therapy prolongs survival after surgical resection of cardiac sarcoma; however, 5-year survival rates do not significantly differ from those observed with surgery alone [ 6 ]. Herein we report the outcome of a patient who received postoperative carbon-ion radiotherapy (CIRT) and chemotherapy for spindle cell sarcoma of the heart.…”

Section: Introductionmentioning

confidence: 99%

Primary spindle cell sarcoma of the heart treated with carbon-ion radiotherapy: Case report

Shibasaki

Toyoda

Takei

et al. 2020

International Journal of Surgery Case Reports

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Highlights Primary cardiac tumors are rare. Seventy-five percent of the tumors are benign and 25 % are malignant. Primary cardiac sarcoma is a rare malignant cardiac neoplasm with a poor prognosis. No evidence-based guidelines exist regarding optimal surgical treatment of primary cardiac sarcomas. Systemic chemotherapy is indicated for patients with widespread or unresectable malignancies.

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“…All the studies included were retrospective nonrandomized studies, with seven of them being multicentre (Table 1). [9][10][11][15][16][17][18]…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Surgical and multimodality treatment of cardiac sarcomas: A systematic review and meta‐analysis

Torabi

Rad

Vardanyan

et al. 2021

Journal of Cardiac Surgery

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Introduction: Primary cardiac sarcomas (PCSs) are an extremely rare and aggressive type of malignancies that have been described only by a limited number of observational studies. This study aimed to evaluate the currently existing evidence comparing surgical to multimodality treatment of PCS.Methods: We systematically reviewed Embase, MEDLINE, Cochrane Database, and Google Scholar, from inception to December 2020, for original articles about surgical and multimodality treatment of PCS. The outcomes included were mortality at various time points, resection margin status, and mean estimated survival. The pooled treatment effects were calculated using a random-effects model.Results: Ten studies including a total of 1570 patients met our inclusion criteria. Surgery was associated with significantly lower mortality when compared to conservative treatment at 1, 2, and 3 years, whereas no significant difference was found at 5 years. Furthermore, multimodality treatment showed significantly lower mortality at 1 year when compared to surgery alone, but not at 2 and 5 years. We found no difference in mortality between angiosarcomas and other PCS subtypes. Conclusion:Overall, surgery was found to provide a significant mortality advantage to PCS patients up to 3 years following treatment. Multimodality treatment might be of additional benefit, although only within the first year. Prospective randomized studies are needed to further explore these differences in the treatment of PCS.

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Postoperative chemotherapy and radiation improve survival following cardiac sarcoma resection

Cited by 28 publications

References 25 publications

Primary cardiac sarcoma: a case report of a therapeutic challenge

Primary cardiac sarcoma: a case report of a therapeutic challenge

Primary spindle cell sarcoma of the heart treated with carbon-ion radiotherapy: Case report

Surgical and multimodality treatment of cardiac sarcomas: A systematic review and meta‐analysis

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