Prognostic Factors for Long-Term Survival after Surgical Resection of Primary Cardiac Sarcoma

Author:

Aboud Anas1,Farha Kassar2,Hsieh Wan Chin3,Brasch Frank4,Ensminger Stephan1,Gummert Jan2,Renner André2

Affiliation:

1. Department of Cardiac and Thoracic Vascular Surgery, University of Schleswig-Holstein, Lübeck Campus, Lübeck, Germany

2. Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany

3. Department of Cardiovascular Surgery, First Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic

4. Department of Pathology, Academic Teaching Hospital Bielefeld, Bielefeld, Germany

Abstract

Background Primary cardiac sarcoma (CS) is an extremely rare disease. This study aims to identify possible prognostic factors for long-term survival. Methods A total of 17 consecutive patients who were treated for primary CS between 2003 und 2018 at two cardiac centers were investigated. Clinical data and histological characteristics of the tumors were analyzed. Long-term follow-up of all patients were performed. Results The median age was 54 years (range: 23–74). The tumors originated from the left side of the heart in nine patients. Histologically, there were four angiosarcomas, three intimal sarcomas, and three synovial sarcomas. One- and 7-year survivals were 81.9 and 18.2%, respectively. Low expression levels of Ki-67 tended to be associated with increased survival (log-rank p = 0.06). Adjuvant chemotherapy but not radiotherapy regardless of existing metastases was associated with significantly increased survival (log-rank p = 0.001). Conclusion Angiosarcoma was the most common type of CS. The survival of CS patients is poor but prognostic factors, such as Ki-67, may help estimate the course of the disease. Survival could be improved significantly with chemotherapy.

Publisher

Georg Thieme Verlag KG

Subject

Cardiology and Cardiovascular Medicine,Pulmonary and Respiratory Medicine,Surgery

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