Abstract
BackgroundPrimary tumors of the heart represent an exceedingly rare entity in cardiac surgery and literature regarding management and outcome is rare. The aim of this study was to translate 15 years of experience in both multimodal diagnosis and surgical treatment of one of the largest collective of patients in literature into a detailed analysis of patient prognosis, mean survival and best treatment approach.Methods and resultsAll patients who underwent open-heart surgery at the Hospital of the Medical University of Vienna for primary cardiac tumor excision between 1999 and 2014 were analyzed retrospectively. Mean follow-up was 76.8 months. Descriptive statistical measurements were applied.113 patients were identified, 71 (62.8%) female and 42 (37.2%) male patients with a mean age of 57.9 ± 16.8 years. 90.3% (n = 102) masses were benign, 9.7% (n = 11) were malignant. Complete resection was possible for 99% and for 18.2% of benign and malignant masses, respectively. 2.9% of benign tumors and 45.5% of malignant tumors relapsed. The 30-day mortality was 1.8% (n = 2). Mean survival was 187.2 ± 2.7 months and 26.2 ± 9.8 months for benign and malignant pathologies, respectively. Sarcoma patients who underwent adjuvant combination-chemotherapy or adjuvant mono-chemotherapy and radiation had a statistically significant survival advantage of 41.5 months.ConclusionPrimary cardiac tumors remain challenging in the clinical setting. A multimodality treatment approach especially for sarcoma patients prolongs mean survival and should be regarded as the standard of care.
Highlights
Primary tumors of the heart represent an exceedingly rare entity in cardiac surgery and literature regarding management and outcome is rare
Primary cardiac tumors remain challenging in the clinical setting
Based upon the data of 22 large autopsy series reported by McAllister et al, the frequency of primary cardiac tumors is approximately 0.02%, corresponding to 200 tumors in 1 million autopsies [1,2]
Summary
Primary tumors of the heart represent an exceedingly rare entity in cardiac surgery and literature regarding management and outcome is rare. The aim of this study was to translate 15 years of experience in both multimodal diagnosis and surgical treatment of one of the largest collective of patients in literature into a detailed analysis of patient prognosis, mean survival and best treatment approach. Cardiac tumors, both benign and malignant represent extremely rare diseases and literature on both management and outcome is quite limited. Bahnson and Newman [5] performed the first successful open surgical excision of a primary cardiac tumor using the inflow obstruction technique in 1952 and only 2 years later Crafoord et al reported the first successful atrial myxoma excision using a heart lung bypass [6]
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