Trends in treatments and in-hospital outcomes of primary malignant cardiac tumors: A 16-year U.S. nationwide study.

Abstract

e18756 Background: Primary malignant cardiac tumors are a rare but highly aggressive disease. Recent studies have quantified its long-term survival and the efficiencies of different treatment modalities. However, the trends in treatment patterns and in-hospital outcomes in the United States are still poorly understood. Methods: The National Inpatient Sample (NIS) was queried to identify adult patients (age ≥ 18) who were diagnosed with primary malignant cardiac tumors (ICD-9: 164.1; ICD-10: C38.0). Surgical treatments and chemotherapy were identified using the corresponding procedure and ICD codes. The national estimates were generated based on the weighted values of the hospitalizations. Results: From 2002 to 2017, 6,494 malignant cardiac tumor-related hospitalizations were identified. The mean age was 53.8 ± 17.5 years, 55.9% White, and 47.9% women. There was an increasing trend in the incidence over the study period, from 1.15 per 100,000 NIS admissions in 2002 to 1.49 per 100, 000 NIS admissions in 2017 (P for trend < 0.001). 1708 (26.3%) patients received some forms of surgery: 733 (11.2%) underwent surgical excision of the tumor, 585 (9.0%) received pericardiotomy, and 397 (6.1%) underwent pericardiectomy. A decreasing trend in surgical therapy was observed (22.0% in 2002 to 16.8% in 2017, P for trend < 0.001). 1403 (21.6%) patients received chemotherapy, with a significant decreasing trend over time (25.8% in 2002 to 19.6% in 2017, P for trend < 0.001). The in-hospital mortality of the entire cohort was 11.1%, which remained unchanged over time (P for trend > 0.05). Conclusions: This study demonstrates that although malignant cardiac tumor-related hospitalizations were increasing between 2002 and 2017, the uses of surgical therapy and chemotherapy were decreasing. The in-hospital mortality was high but remained stable over the study period.