Primary Cardiac Sarcoma: Clinical Characteristics and Prognostic Factors over the Past 2 Decades

Area of Science:

• Cardiovascular Oncology
• Epidemiology of Rare Cancers
• Surgical Oncology

Background:

• Primary cardiac sarcomas (PCS) are exceptionally rare malignant heart tumors with limited treatment options and a poor prognosis.
• Existing data on PCS epidemiology and treatment effectiveness, particularly surgical resection, are scarce and conflicting.
• This study aims to elucidate the epidemiological characteristics, survival outcomes, and prognostic factors of PCS.

Purpose of the Study:

• To investigate the epidemiological features of primary cardiac sarcomas (PCS).
• To analyze survival outcomes associated with PCS.
• To identify independent prognostic factors influencing PCS patient survival.

Main Methods:

• Utilized the Surveillance, Epidemiology, and End Results (SEER) database for a retrospective cohort study (2000-2017).
• Included 362 patients, analyzing demographics, clinical characteristics, overall mortality (OM), and PCS-specific mortality (CSM).
• Employed multivariate Cox proportional hazard regression and Kaplan-Meier survival analysis with log-rank testing.

Main Results:

• Older age (80+) and distant metastases were independently associated with significantly higher overall and cancer-specific mortality.
• Cardiac rhabdomyosarcoma demonstrated the lowest cancer-specific mortality (CSM) and overall mortality (OM).
• Surgical resection showed improved survival in crude analysis but not in multivariate analysis after adjusting for covariates.

Conclusions:

• Cardiac rhabdomyosarcoma is associated with the most favorable prognosis among PCS subtypes.
• Advanced age and metastatic disease are critical independent predictors of poor prognosis in PCS.
• Surgical resection did not significantly impact overall or cancer-specific mortality in multivariate analysis, suggesting palliative care may be more appropriate for some patients.