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Malignant primary cardiac tumors: review of a single institution experience
Lijo Simpson1, Shaji K Kumar, Scott H Okuno
1Division of Medical Oncology, Mayo Clinic Cancer Center, Mayo Clinic, Rochester, MN 55905, USA.
Insights
Primary cardiac sarcomas are rare and lethal. Complete surgical excision offers improved survival, but innovative treatments are needed for this poor-prognosis disease.
Area of Science:
- Cardiology
- Oncology
- Surgical Oncology
Background:
- Primary cardiac sarcomas are rare malignant tumors affecting the heart.
- This study reviews the Mayo Clinic's 32-year experience with 34 primary cardiac sarcoma patients.
Purpose of the Study:
- To analyze the clinical characteristics, treatment approaches, and outcomes of primary cardiac sarcoma patients.
- To identify prognostic factors influencing survival in cardiac sarcoma.
Main Methods:
- Retrospective review of 34 primary cardiac sarcoma patients diagnosed between 1975 and 2007.
- Analysis of presenting symptoms, staging, treatment modalities, and patient outcomes.
Main Results:
- Angiosarcoma was the most common type (41%), with a median age of 44.
- Complete surgical excision was associated with significantly longer median survival (17 vs. 6 months).
- Patients with angiosarcoma or metastatic disease had poorer survival outcomes.
Conclusions:
- Cardiac sarcomas are rare, lethal, and have a poor prognosis compared to extracardiac sarcomas.
- Complete surgical resection is crucial for improving patient survival.
- Novel therapeutic strategies are essential for managing this disease.
Background:
Primary cardiac sarcomas are uncommon. The authors undertook to review the Mayo Clinic's experience with primary cardiac sarcomas consisting of 34 patients seen over a 32-year period.
Methods:
The patient database at the Mayo Clinic was searched to identify patients with malignant tumors of the heart seen during the 32-year period between 1975 and 2007. Thirty-four patients with primary cardiac sarcomas were identified and their medical records reviewed for details pertaining to presenting symptoms, staging modalities, treatment approaches, and outcomes.
Results:
Of the 34 patients, 17 were men and 17 were women. The median age was 44 years. The mean duration of symptoms at the time of diagnosis was 3.6 months. The most common histologic type was angiosarcoma (41%). The median follow-up for the entire group was 12 months (range, 0-61 months). The median survival for those who underwent a complete surgical excision was 17 months compared with 6 months for those in whom a surgical complete remission could not be achieved (P = .01). Patients with angiosarcoma had a lower survival compared with patients with other histologies (5 months vs 17 months; P = .01). The median survival of patients with metastatic disease was 5 months versus 15 months in patients without metastatic disease (P = .03 by the log-rank test).
Conclusions:
Cardiac sarcomas remain a rare but lethal disease. Compared with extracardiac sarcomas, the prognosis for patients with cardiac sarcomas remains very poor. A complete surgical excision should be performed if possible. Innovative treatment strategies are required.
