Surgery for angiosarcoma and other cardiac sarcomas: A single-institution experience

Area of Science:

• Cardiology
• Oncology
• Surgical Oncology

Background:

• Cardiac sarcomas are rare and aggressive cancers with limited treatment options.
• Angiosarcoma is the most common subtype but is poorly understood.
• These tumors carry a poor prognosis, necessitating research into clinical characteristics and prognostic factors.

Purpose of the Study:

• To compare clinical features and surgical approaches for different cardiac sarcoma subtypes.
• To identify factors influencing patient prognosis after surgical intervention.
• To characterize the specific clinical presentation of angiosarcoma.

Main Methods:

• Retrospective analysis of 40 patients who underwent surgery for cardiac sarcomas.
• Comparison of clinical characteristics, tumor location, and surgical techniques between angiosarcoma and other subtypes.
• Application of Kaplan-Meier curves and multivariable Cox regression to determine survival predictors.

Main Results:

• Angiosarcomas were more frequently associated with pericardial effusion (85% vs. 50%).
• Early surgery (median 24 days) was performed irrespective of histological type.
• R0 resection (complete tumor removal) was the sole independent predictor of improved postoperative survival (HR 0.423, P=0.039).

Conclusions:

• Angiosarcoma exhibits distinct clinical features, locations, surgical requirements, and prognoses compared to other cardiac sarcomas.
• Complete tumor resection (R0) is critical for enhancing survival outcomes.
• While early surgery is recommended for all subtypes, prognosis may be worse with positive margins, high Ki-67 index, younger age, or angiosarcoma.