Surgical Management of Primary and Metastatic Cardiac Malignancies: A 20-Year Single-Center Experience

Malignant cardiac tumors are rare and have a poor prognosis. Surgical resection is performed for symptom relief and survival benefit, but its efficacy is limited. We reviewed our 20-year single-institution experience with primary and metastatic malignant cardiac tumors.

We retrospectively reviewed 15 patients who underwent resection for histologically confirmed malignant cardiac tumors between 2006 and 2025. Data included tumor characteristics, resection status, and survival outcomes.

Of 15 patients, 7 (46.7%) had primary tumors (most common: angiosarcoma) and 8 (53.3%) had metastatic lesions. The right atrium was the most frequent site (60.0%). Complete (R0) resection was achieved in only 3 cases (20.0%). Median overall survival (OS) for the cohort was 11 months. Patients with angiosarcoma had particularly poor outcomes (median OS: 5 months). One patient with metastatic thymic carcinoma achieved long-term survival (>15 years) following multimodal therapy. Adjuvant therapy was administered in 7 patients (46.7%). No 30-day postoperative mortality occurred.

Surgical resection of malignant cardiac tumors is feasible with acceptable perioperative safety. Although R0 resection is rarely attainable and long-term outcomes remain poor, particularly for high-grade sarcomas, a multimodal approach is essential to optimize outcomes in selected patients.