Abstract
Purpose
The literature on primary malignant cardiac tumors is relatively limited because of their rare incidence. This study aimed to provide a proposed treatment strategy for primary malignant cardiac tumors.
Methods
The follow-up outcomes of 29 patients with primary malignant cardiac tumors operated, and 8 primary malignant cardiac tumors considered not operable from 1985 to 2013 in the First Affiliated Hospital of China Medical University were retrospectively analyzed.
Results
Of operation receivers, ten patients had positive surgical margins and nineteen patients had negative surgical margins. Eleven patients received a post-operative neoadjuvant chemotherapy. Patients rejected to surgery had a lower survival compared with operation receivers (15 vs 23 months, P = 0.011). However, there were no significant differences in survival in patients rejected to surgery than in patients who had positive surgical margins (15 vs 16 months, P = 0.874). Patients who had positive surgical margins had a median overall survival duration of only 16 months, whereas patients with negative surgical margins had a median overall survival duration of 27 months (P = 0.002). There were no significant differences in survival in patients with receiving a post-operative adjuvant chemotherapy than in the rest of the population (20 vs 25 months, P = 0.150).
Conclusions
The prognosis for patients with primary malignant cardiac tumors remains very poor. Each patient should be managed on an individual basis, and variety of treatment strategy should be performed. Maximizing the possibility of obtaining negative surgical margins may prolong survival.
Similar content being viewed by others
References
Araoz PA, Eklund HE, Welch TJ, Breen JF (1999) CT and MR imaging of primary cardiac malignancies. Radiographics 19(6):1421–1434
Bakaeen FG, Jaroszewski DE, Rice DC, Walsh GL, Vaporciyan AA, Swisher SS, Benjamin R, Blackmon S, Reardon MJ (2009) Outcomes after surgical resection of cardiac sarcoma in the multimodality treatment era. J Thorac Cardiovasc Surg 137(6):1454–1460
Barnes AR, Beaver DC, Snell AM (1934) Primary sarcoma of heart: report of a case with electrocardiographic and pathological studies. Am Heart J 9(3):480
Blackmon SH, Patel AR, Bruckner BA, Beyer EA, Rice DC, Vaporciyan AA, Wojciechowski Z, Correa AM, Reardon MJ (2008) Cardiac autotransplantation for malignant or complex primary left-heart tumors. Tex Heart Inst J 35(3):296–300
Burke AP, Cowan D, Virmani R (1992) Primary sarcomas of the heart. Cancer 69(2):387–395
Butany J, Nair V, Naseemuddin A, Nair GM, Catton C, Yau T (2005) Cardiac tumours: diagnosis and management. Lancet Oncol 6(4):219–228
Catton C (2008) The management of malignant cardiac tumors: clinical considerations. Semin Diagn Pathol 25(1):69–75
Cheitlin MD, DeCastro CM, Knowles DM, Fenoglio JJ, McAllister HA (1975) Clinical pathologic conference: heart neoplasm. Am Heart J 90(2):248–254
Donsbeck AV, Ranchere D, Coindre JM, Le Gall F, Cordier JF, Loire R (1999) Primary cardiac sarcomas: an immunohistochemical and grading study with long-term follow-up of 24 cases. Histopathology 34(4):295–304
Fujita Y, Ikebuchi M, Tarui S, Irie H (2009) Successful combined treatment of primary cardiac malignant lymphoma with urgent cardiac operation and chemotherapy. Circ J 73(5):967–969
Gowdamarajan A, Michler RE (2000) Therapy for primary cardiac tumors: is there a role for heart transplantation? Curr Opin Cardiol 15(2):121–125
Isambert N, Ray-Coquard I, Italiano A, Rios M, Kerbrat P, Gauthier M, Blouet A, Chaigneau L, Duffaud F, Piperno-Neumann S, Kurtz JE, Girard N, Collard O, Bompas E, Penel N, Bay JO, Guillemet C, Collin F, Blay JY, Le Cesne A, Thariat J (2014) Primary cardiac sarcomas: a retrospective study of the French Sarcoma Group. Eur J Cancer 50(1):128–136
Iwa N, Masuda K, Yutani C, Kobayashi TK (2009) Imprint cytology of primary cardiac sarcomas: a report of 3 cases. Ann Diagn Pathol 13(4):239–245
Llombart-Cussac A, Pivot X, Contesso G, Rhor-Alvarado A, Delord JP, Spielmann M, Türsz T, Le Cesne A (1998) Adjuvant chemotherapy for primary cardiac sarcomas: the IGR experience. Br J Cancer 78(12):1624–1628
Lund JT, Ehman RL, Julsrud PR, Sinak LJ, Tajik AJ (1989) Cardiac masses: assessment by MR imaging. AJR 152(3):469–473
McAllister HA Jr, Fenoglio JJ Jr (1975) Cardiac involvement in Whipple’s disease. Circulation 52(1):152–156
Meng Q, Lai H, Lima J, Tong W, Qian Y, Lai S (2002) Echocardiographic and pathologic characteristics of primary cardiac tumors: a study of 149 cases. Int J Cardiol 84(1):69–75
Messias P, Bernardo J, Antunes MJ (2008) Primary left atrial haemangioendothelioma. Interact CardioVasc Thorac Surg 7(5):945–946
Miralles A, Bracamonte I, Sconcul H, Diaz del Castillo R, Akhtar R, Bors V, Pavie A, Gandjbackhch I, Cabrol C (1991) Cardiac tumors: clinical experience and surgical results in 74 patients. Ann Thorac Surg 52(4):886–895
Movsas B, Teruya-Feldstein J, Smith J, Glatstein E, Epstein AH (1998) Primary cardiac sarcoma: a novel treatment approach. Chest 114(2):648–652
Perchinsky MJ, Lichtenstein SV, Tyers GF (1997) Primary cardiac tumors: forty years’ experience with 71 patients. Cancer 79(9):1809–1815
Radulescu D, Pripon S, Radulescu LI, Constantea NA, Gulei I (2008) A rare case of primitive right atrium angio-sarcoma with favorable outcome, in a young female. Case report and literature review. Rev Med Chil 136(10):1311–1316
Reardon MJ, Malaisrie SC, Walkes JC, Vaporciyan AA, Rice DC, Smythe WR, DeFelice CA, Wojciechowski ZJ (2006a) Cardiac autotransplantation for primary cardiac tumors. Ann Thorac Surg 82:645–650
Reardon MJ, Walkes JC, Defelice CA, Wojciechowski Z (2006b) Cardiac autotransplantation for surgical resection of a primary malignant left ventricular tumor. Tex Heart Inst J 33(4):495–497
Schattenberg TT (1968) Echocardiographic diagnosis of left atrial myxoma. Mayo Clin Proc 43(9):620–627
Shapiro LM (2001) Cardiac tumours: diagnosis and management. Heart 85(2):218–222
Silverman NA (1980) Primary cardiac tumors. Ann Surg 191(2):127–138
Simpson L, Kumar SK, Okuno SH, Schaff HV, Porrata LF, Buckner JC, Moynihan TJ (2008) Malignant primary cardiac tumors: review of a single institution experience. Cancer 112(11):2440–2446
Yu L, Shi E, Gu T (2010) Fibrosarcoma of the left superior pulmonary vein with extension to the left atrium. J Card Surg 25(6):698
Yu L, Shi E, Gu T (2011a) Primary pulmonary artery endothelial sarcoma. J Card Surg 26(2):217–218
Yu L, Shi E, Gu T, Xiu Z, Fang Q, Wang C (2011b) Intravenous leiomyomatosis with intracardiac extension: a report of two cases. J Card Surg 26(1):56–60
Conflict of interest
We declare that we have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Yu, L., Gu, T., Shi, E. et al. Primary malignant cardiac tumors. J Cancer Res Clin Oncol 140, 1047–1055 (2014). https://doi.org/10.1007/s00432-014-1651-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00432-014-1651-1