Primary malignant tumors of the heart: Outcomes of the surgical treatment

Pacini, Davide; Careddu, Lucio; Pantaleo, Antonio; Parolari, Alessandro; Leone, Ornella; Daprati, Andrea; Gargiulo, Gaetano; Bartolomeo, Roberto Di

doi:10.1177/0218492315573674

Cited by 27 publications

(21 citation statements)

References 21 publications

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“…2 Our data show similar distributions of angiosarcoma (25.8%) and rhabdomyosarcoma (2.6%) but a much lower prevalence of leiomyosarcoma (3.7%). The predominance of angiosarcoma was also reported previously by researchers in Italy (28.6%), 18 the Mayo Clinic (41%), 19 and the British Columbia Registry. 20 In contradistinction, a single study from Germany reported the predominance of undifferentiated sarcoma, 20 which may suggest either regional variances in histological distribution or differences in histological classifications across the eras.…”

Section: Discussionsupporting

confidence: 85%

Characteristics and Survival of Malignant Cardiac Tumors

et al. 2015

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Background-The aim of this study was to investigate the incidence, histopathology, demographics, and survival associated with primary malignant cardiac tumors (PMCTs). Methods and Results-We queried the Surveillance, Epidemiology and End Results (SEER) 18 registry from the National Cancer Institute for all PMCTs diagnosed from 1973 to 2011. We describe PMCT histopathology and incidence, comparing characteristics and survival of these patients with those of patients with extracardiac malignancies of similar histopathology. From a total of 7 384 580 cases of cancer registered in SEER, we identified 551 PMCTs (0.008%). The incidence of PMCT diagnosis is 34 cases per 100 million persons and has increased over time (25.1 in 1973-1989, 30.2 in 1990-1999, and 46.6 in 2000-2011). Most patients are female (54.1%) and white (78.6%) with median age at diagnosis of 50 years. The most common PMCTs are sarcomas (n=357, 64.8%), followed by lymphomas (n=150, 27%) and mesotheliomas (n=44, 8%). Most patients are diagnosed with tissue sample (96.8%). Although use of chemotherapy is not documented in SEER, 19% of patients received radiation and 44% had surgery. After a median follow-up of 80 months, 413 patients had died. The 1-, 3-, and 5-year survival rates were 46%, 22%, and 17% and have improved over the eras, with 1-, 3-, and 5-year survival rates of 32%, 17%, and 14% for 1973 to 1989 and 50%, 24%, and 19% for 2000 to 2011 (P=0.009). Cardiac sarcomas and mesotheliomas are the most lethal PMCTs, with 1-, 3-, 5-year survival rates of 47%, 16%, and 11% and of 51%, 26%, and 23% compared with 59%, 41%, and 34% for lymphomas, respectively (log rank test P<0.001). Patients with cardiac lymphomas and sarcomas are younger and have worse survival than patients with extracardiac disease of similar histopathology (P<0.001). Conclusions-PMCTs are extremely rare and continue to be associated with poor prognosis. Over the past 5 decades, the incidence and survival of patients diagnosed with PMCT appear to have increased.

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Section: Discussionsupporting

confidence: 85%

Characteristics and Survival of Malignant Cardiac Tumors

et al. 2015

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“…MCTs are extremely rare and associated with poor prognoses 2) in a field where data are very sparse. MCT studies were reported previously by researchers in Italy, 10) the Mayo Clinic 11) and the British Columbia Registry 12) as well as the Spanish Tertiary Surgical Center. 13) However, limited studies have been done in China.…”

Section: Discussionmentioning

confidence: 82%

“…Only a few articles reported a similar result. 10,14) According to the guideline for pericardial diseases, 20) one of the most common non-infectious causes for pericardial effusion is pericardial tumor, e.g., primary cardiac lymphoma. 21) A Chinese study also reported that the proportion of pericardium involvement in the malignant tumors (25.8%) was significantly higher than in benign tumors.…”

Section: Discussionmentioning

confidence: 99%

Outcome and Pathological Characteristics of Primary Malignant Cardiac Tumors

et al. 2019

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The literature on malignant cardiac tumors is relatively limited because they are rare, especially among the Chinese population. We analyzed 14 patients diagnosed with malignant cardiac tumors in Fuwai Hospital and present the results of surgical treatments on the tumors. The mean age at tumor diagnosis was 47 years in a male-dominated cohort. There was a high frequency of pericardial effusion and coronary artery involvement in our group. We compared the survival times of patients who received different treatments and found that surgery improved prognosis of tumors, especially for patients who underwent orthotopic heart transplantation.

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“…Gross total resection can be performed successfully for most tumours in the left or right atrium, especially myxomas with the tumour pedicle connected to the atrial septum. However, gross total resection is much more difficult to perform for valvular tumours and invasive malignant tumours (11,14). For these patients, cardiac reconstruction and valve repair or replacement should be performed simultaneously to achieve optimal results.…”

Section: Discussionmentioning

confidence: 99%

“…Most cardiac primary malignant tumours are associated with a poor prognosis, with even patients who undergo adjuvant chemotherapy or radiotherapy showing poor postoperative survival (1,11,14,15). A recent study by Pacini and colleagues (14) reported an average survival time of 28.8±28 months in 14 patients with cardiac malignant tumours treated by surgery combined with radiotherapy and adjuvant chemotherapy. Simpson et al (16) reported that the median survival for patients who underwent complete surgical excision was 17 months compared to 6 months for patients whose tumours could not be completely removed by surgery.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of surgical treatment in 115 patients with primary cardiac tumours: a 15-year experience at a single institution

Zhou

et al. 2017

J. Thorac. Dis.

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In the Chinese population, the incidence of primary cardiac tumours is mainly attributable to myxomas. Gross total resection is a safe and effective treatment for both benign and malignant tumours. Long-term survival is satisfactory for benign tumours but low for malignant tumours, and a risk of recurrence exists. Postoperative chemotherapy or radiotherapy may be needed to achieve better outcomes.

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Primary malignant tumors of the heart: Outcomes of the surgical treatment

Abstract: The treatment outcome for patients affected by primary malignant heart tumors remains poor. Aggressive surgery alone does not provide good results in terms of survival rate. A new multidisciplinary approach is mandatory to improve long-term survival.

Cited by 27 publications

References 21 publications

Characteristics and Survival of Malignant Cardiac Tumors

Characteristics and Survival of Malignant Cardiac Tumors

Outcome and Pathological Characteristics of Primary Malignant Cardiac Tumors

Outcomes of surgical treatment in 115 patients with primary cardiac tumours: a 15-year experience at a single institution

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