Ibrahim Sultan1, Valentino Bianco2, Andreas Habertheuer2, Arman Kilic3, Thomas G Gleason3, Edgar Aranda-Michel2, Matthew E Harinstein4, Deirdre Martinez-Meehan2, George Arnaoutakis5, Olugbenga Okusanya6. 1. Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. Electronic address: sultani@upmc.edu. 2. Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania. 3. Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania; Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. 4. Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. 5. Department of Surgery, University of Florida, Gainesville, Florida. 6. Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address: https://twitter.com/okusanyamd.
Abstract
BACKGROUND: Data on primary cardiac malignancies are limited to small single-center studies. OBJECTIVES: The aim of the current study was to provide detailed outcomes for treatment of primary cardiac malignancies from a multi-institutional database. METHODS: Outcomes were acquired from the National Cancer Database for all solid primary cardiac malignancies from 2004 to 2016. The primary outcome was long-term survival. Logistic regression was used to determine factors associated with mortality. RESULTS: A total of 100,317 cardiac tumors were identified, of which 826 (0.8%) were primary malignant tumors. After exclusion criteria, the cohort consisted of 747 patients (median age 53 years, 47.5% women). Most tumors were primary sarcomas (88.5%), the majority of which were hemangiosarcoma (40.4%). A total of 136 patients received no therapy, 113 received just chemotherapy, and 20 received just radiation. Surgery was performed in 442 (59.2%) patients including 255 patients undergoing multimodal therapy (surgery with chemotherapy, radiation, or chemoradiation). With surgery alone, 90-day mortality was 29.4%. Overall 30-day, 1-year, and 5-year survival rates were 81.2%, 45.3%, and 11.5%, respectively. The surgery group as compared with the no surgery groups had significantly better long-term survival (p < 0.0001). For stage III disease, there was a statistically significant improvement in survival with the addition of chemotherapy to surgery. CONCLUSIONS: Primary cardiac malignancies are rare cancers with dismal long-term survival despite mode of treatment. Patients who underwent surgery and those with stage III disease who received peri-operative chemotherapy had better survival compared with those who did not. However, there was likely a significant selection bias in patients chosen for surgical or medical therapy.
BACKGROUND: Data on primary cardiac malignancies are limited to small single-center studies. OBJECTIVES: The aim of the current study was to provide detailed outcomes for treatment of primary cardiac malignancies from a multi-institutional database. METHODS: Outcomes were acquired from the National Cancer Database for all solid primary cardiac malignancies from 2004 to 2016. The primary outcome was long-term survival. Logistic regression was used to determine factors associated with mortality. RESULTS: A total of 100,317 cardiac tumors were identified, of which 826 (0.8%) were primary malignant tumors. After exclusion criteria, the cohort consisted of 747 patients (median age 53 years, 47.5% women). Most tumors were primary sarcomas (88.5%), the majority of which were hemangiosarcoma (40.4%). A total of 136 patients received no therapy, 113 received just chemotherapy, and 20 received just radiation. Surgery was performed in 442 (59.2%) patients including 255 patients undergoing multimodal therapy (surgery with chemotherapy, radiation, or chemoradiation). With surgery alone, 90-day mortality was 29.4%. Overall 30-day, 1-year, and 5-year survival rates were 81.2%, 45.3%, and 11.5%, respectively. The surgery group as compared with the no surgery groups had significantly better long-term survival (p < 0.0001). For stage III disease, there was a statistically significant improvement in survival with the addition of chemotherapy to surgery. CONCLUSIONS:Primary cardiac malignancies are rare cancers with dismal long-term survival despite mode of treatment. Patients who underwent surgery and those with stage III disease who received peri-operative chemotherapy had better survival compared with those who did not. However, there was likely a significant selection bias in patients chosen for surgical or medical therapy.
Authors: Chetan Shenoy; John D Grizzard; Dipan J Shah; Mahwash Kassi; Michael J Reardon; Marianna Zagurovskaya; Han W Kim; Michele A Parker; Raymond J Kim Journal: Eur Heart J Date: 2021-12-28 Impact factor: 35.855
Authors: Quoc Bui; Tam N M Ngo; Jan Mazur; Vy Pham; Cassady Palmer; Binh Q Truong; Eugene S Chung; Huy G Vuong; Vien T Truong Journal: Cancer Med Date: 2021-11-11 Impact factor: 4.452
Authors: Mark M Aloysius; Sanskriti Shrivastava; Chaitanya Rojulpote; Raza Naseer; Hamza Hanif; Milos Babic; Kenneth Gentilezza; Pranjal K Boruah; Samir Pancholy Journal: Front Cardiovasc Med Date: 2022-08-25