Malignant Cardiac Tumors Research Articles

A Cardiac Tumor and Liver Masses on Point of Care Ultrasound (POCUS): Implications in a Resource-Limited Setting

Malignant cardiac tumors are quite rare, but portend a poor prognosis [1,2]. Early identification and classification are essential given their aggressive nature, particularly when metastases are present [3,4]. Clinical presentations are varied, and detection relies primarily on echocardiography. Thus, cardiac tumors may go undiagnosed in areas where echocardiography is not routinely available [1,5]. In this case, point of care ultrasound (POCUS) rapidly detected a cardiac mass and liver lesions, prompting referral to a central hospital in Malawi for further evaluation. This case highlighted the potential role of POCUS as a readily available tool in a resource-limited setting, serving as a triage point for more definitive diagnosis and management [6-8].

The spectrum of ECG abnormalities in a large cohort of histologically proven cardiac tumors

Abstract Background Cardiac tumors represent a heterogeneous clinical scenario. The role of ECG in the diagnostic work-up remains to be investigated. Objectives To describe the spectrum of electrocardiographic abnormalities in a large cohort of histologically proven cardiac tumors and to evaluate potential red flags of malignancy. Material and Methods 247 consecutive patients with histologically proven cardiac tumors and available ECG at Bologna University Hospital were enrolled. All ECGs were independently analyzed off-line using a manual caliper by two experienced cardiologists who were blinded to clinical information and histological results. In case of disagreements, a third consensus re-assessment was performed to resolve any discrepancies. Multivariable regression analysis was used to assess potential predictors of malignancy among electrocardiographic abnormalities. Results Of 247 patients, 98 (39.7%) had malignant tumors. Compared with patients with benign tumors, those with malignant tumors exhibited a higher heart rate, right axis deviation, greater depolarization, repolarization abnormalities and bradyarrhythmia at presentation. Regarding specific ECG features, a higher heart rate on admission (p=0.001), bradyarrhythmias (p=0.01), ischemic-like repolarization abnormalities (ST-segment deviation, both depression and elevation, and negative T-wave; p<0.001) and low voltages (p=0.005) were identified as independent predictors of malignancy. Conclusion ECG is frequently abnormal in case of malignant cardiac tumors. Some specific electrocardiographic changes could have a supportive role in the diagnostic workup of patients with cardiac tumors by increasing the clinical suspicion of malignancy.ECG Tumors

Syncope as a clinical presentation of cardiac lymphoma: a case report

Primary cardiac lymphoma, an extremely rare type of B-cell non-Hodgkin lymphoma, has an incidence of approximately 0.02-2% among malignant cardiac tumors. It is frequently associated with manifestations such as cardiac rhythm disturbances, refractory pericardial effusion and cardiac masses. Definitive diagnosis is achieved by biopsy, being essential to rule out hematogenous dissemination with PET-CT. The literature indicates a predominance of right chamber involvement and survival that varies significantly according to left ventricular involvement and the presence of arrhythmias. Therapeutic options are not well defined, but chemotherapy such as R-CHOP has shown efficacy, although the prognosis is generally poor due to complications such as disease progression, arrhythmias and sepsis. This case underscores the importance of considering cardiac lymphoma in patients with unexplained cardiac symptoms, highlighting the need for a multidisciplinary and specific diagnostic and therapeutic approach.

Treatment of malignant primary cardiac tumors requires attention to cardiovascular complications: a single-center, retrospective study.

Malignant primary cardiac tumors require multimodal approaches including surgery, chemotherapy and radiotherapy, but these treatments can be associated with cardiovascular complications. However, few reports have described the cardiovascular complications related to primary cardiac tumor treatment because of their rarity. Clinical records of patients with primary cardiac tumors treated at Kyushu University Hospital from January 2010 to August 2021 were retrospectively examined. Of the 47 primary cardiac tumor patients, 13 (28%) were diagnosed with malignancy, including 5 angiosarcomas, 3 intimal sarcomas, 3 diffuse large B-cell lymphomas, 1 Ewing's sarcoma and 1 fibrosarcoma. Cardiovascular events were observed in 10 patients (77%), including cardiac dysfunction in 6 patients, arrhythmias in 5 patients, right heart failure in 2 patients, and excessively prolonged prothrombin time due to the combination of warfarin and chemotherapy in 1 patient. Two patients who showed notable cardiac complications are described. Case A involved a 69-year-old woman who underwent surgery for a left atrial intimal sarcoma, followed by postoperative chemotherapy with doxorubicin plus ifosfamide and radiotherapy. After three cycles of chemotherapy and sequential radiotherapy, her left ventricular ejection fraction decreased to 34%, and ongoing heart failure therapy was required. Case B involved a 66-year-old man who received chemotherapy for primary cardiac lymphoma, resulting in tumor shrinkage. However, due to tumor involvement of the intraventricular septum, atrioventricular block developed, requiring cardiac pacemaker implantation. High incidences of cardiac failure and arrhythmias were observed during multimodal treatments for malignant primary cardiac tumors. Proper management of complications may lead to a favorable prognosis in patients with malignant primary cardiac tumors.

Évolution fatale d'une résection complète d'un sarcome cardiaque pléomorphe indifférencié : à propos d'un cas

IntroductionUndifferentiated pleomorphic sarcoma (UPS) is a very rare malignant primary cardiac tumor with a poor prognosis. ObservationA 34-year-old woman complained of dyspnea evolving in a febrile context with altered general condition: Transthoracic echocardiography (TTE) revealed a left intra-atrial mass measuring 51/26 mm in diameter. A thoracic computed tomography (CT) revealed a mass occupying the left atrium measuring 42/28/34 mm, associated with two pulmonary metastases. The cardiac mass was resected and the postoperative suites were fatal. Histological diagnosis was UPS. ConclusionWe present an atypical case of invasive UPS, which was surgically resected and scheduled for radio-chemotherapy with a fatal outcome.

Association between gut microbiota and malignant cardiac tumors: A two-sample Mendelian randomization study.

Recent studies provide compelling evidence linking the gut microbiota to most cancers. Nevertheless, further research is required to establish a definitive causal relationship between the gut microbiota and malignant cardiac tumors. The genome-wide association studies (GWAS) data on the human gut Microbiota, included in the IEU Open GWAS project, was initially collected by the MiBioGen consortium. It encompasses 14,306 individuals and comprises a total of 5,665,279 SNPs. Similarly, the GWAS data on malignant cardiac tumors, also sourced from the IEU Open GWAS project, was initially stored in the finnGen database, including 16,380,303 SNPs observed within a cohort of 174,108 individuals within the European population. Utilizing a two-sample Mendelian randomization (MR) methodology, we examined whether there exists a causal association between the gut microbiota and cardiac tumors. Additionally, to bolster the credibility and robustness of the identified causal relationships, we conducted an extensive array of sensitivity analyses, encompassing Cochran's Q test, MR-PRESSO tests, MR-Egger interpret test, directionality test and leave-one-out analysis. Our analysis unveiled seven distinct causal associations between genetic susceptibility in the gut microbiota and the incidence of malignant cardiac tumors. Among these, the Family Rikenellaceae, genus Eubacterium brachy group, and genus Ruminococcaceae UCG009 exhibited an elevated risk of cardiac tumors, while the phylum Verrucomicrobia, genus Lactobacillus, genus Ruminiclostridium5, and an unknown genus id.1868 were genetically linked to a reduced risk of cardiac tumors. The causal relationship between these two bacteria, belonging to the phylum Verrucomicrobia (OR = 0.178, 95% CI: 0.052-0.614, p = 0.006) and the genus Ruminococcaceae UCG009 (OR = 3.071, 95% CI: 1.236-7.627, p = 0.016), and cardiac tumors was further validated through sensitivity analyses, reinforcing the robustness and reliability of the observed associations. Our MR analysis confirms that the phylum Verrucomicrobia displays significant protection against cardiac tumor, and the genus Ruminococcaceae UCG009 leads to an increasing risk of cardiac tumor.

Multimodality Imaging of Cardiac Myxomas.

Cardiac myxomas are the most common benign cardiac neoplasms. Echocardiography is the first-line imaging modality used to analyze cardiac masses, allowing the detection of tumor location, size, and mobility. However, additional imaging techniques are required to confirm the diagnosis, evaluate tissue characteristics of the mass, and assess potential invasion of surrounding structures. Second-line imaging includes cardiac magnetic resonance imaging (MRI) and/or computed tomography (CT) depending on availability and the patient's characteristics and preferences. The advantages of CT include its wide availability and fast scanning, which allows good image quality even in patients who have difficulty cooperating. MRI has excellent soft-tissue resolution and is the gold standard technique for noninvasive tissue characterization. In some cases, evaluation of the tumor metabolism using 18F-fluorodeoxyglucose positron emission tomography with CT may be useful, mainly if the differential diagnosis includes primary or metastatic cardiac malignancies. A cardiac myxoma can be identified by its characteristic location within the atria, typically in the left atrium attached to the interatrial septum. The main differential diagnoses include physiological structures in the atria like crista terminalis in the right atrium and the coumadin ridge in the left atrium, intracardiac thrombi, as well as other benign and malignant cardiac tumors. In this review paper, we describe the characteristics of cardiac myxomas identified using multimodality imaging and provide tips on how to differentiate myxomas from other cardiac masses.

Spectrum of electrocardiographic abnormalities in a large cohort of cardiac masses

BackgroundCardiac masses represent a heterogeneous clinical scenario. Potential electrocardiographic (ECG) red flags of malignancy remain to be investigated. ObjectivesThe purpose of this study was to describe the spectrum of ECG abnormalities in a large cohort of cardiac masses and to evaluate potential red flags suggestive of malignancy. MethodsThis was an observational cohort study of 322 consecutive patients with a cardiac mass and available ECG at Bologna University Hospital. All masses were diagnosed by histologic examination or, in the case of cardiac thrombi, by radiologic resolution after proper anticoagulant therapy. Multivariable regression analysis was used to assess potential predictors of malignancy among ECG abnormalities. All-cause mortality at follow-up was evaluated. ResultsOf 322 patients, 98 (30.4%) had malignant tumors. Compared with patients with benign masses, those with malignant tumors exhibited a higher heart rate, right-axis deviation, greater depolarization, repolarization abnormalities, and bradyarrhythmia at presentation. Regarding specific ECG features, a higher heart rate on admission (P = .014), bradyarrhythmias (P = .009), ischemic-like repolarization abnormalities (ST-segment deviation, both depression and elevation, and negative T-wave; P <.001), low voltages (P = .001), and right-axis deviation (P = .025) were identified as independent predictors of malignancy. Considering these specific ECG alterations, a malignancy-oriented ECG was associated with higher mortality at follow-up (median 20.7 months). ConclusionECG frequently is abnormal in cases of malignant cardiac tumors. Some specific ECG changes are strongly suggestive for malignancy and type of infiltration.

Right atrial angiosarcoma presenting with pseudoaneurysm and rupture: a case report

Cardiac sarcomas are the predominant type of malignant primary cardiac tumors, especially in cases where the patients are &lt;50 years of age and have a poor prognosis, with a 5-year survival rate of less than 15%. Cardiac angiosarcomas are a common type of cardiac sarcoma. Cardiac angiosarcoma is a highly aggressive tumour, with approximately 75% of the cases originating in the right atrium, and has a higher incidence in males than in females. The present case report describes a 31-year-old woman who was initially suspected of having tuberculous pericarditis and was treated with anti-tuberculous medication. However, cardiac imaging analysis revealed a right atrial pseudoaneurysm with spontaneous rupture of the lateral right atrium. The patient underwent surgical exploration, in which a large mass infiltrating the right atrium, right ventricle, and right pleura with the ruptured right atrium was discovered. Mass excision and right atrial repair were performed, and the patient was admitted to the intensive care unit; however, she subsequently succumbed to her illness. Histopathological examination confirmed the diagnosis of cardiac angiosarcoma. Primary cardiac angiosarcoma is a rare and aggressive tumor that is difficult to diagnose. Most patients have systemic metastasis and a poor prognosis at the time of presentation. A confirmatory diagnosis was made after sample collection, highlighting the need to improve diagnostic and therapeutic methods for this disease.

Abstract 1447: Development of advanced preclinical modeling for a comprehensive characterization of cardiac angiosarcoma biology

Abstract Cardiac angiosarcoma (CAS) is an extremely rare malignant cardiac tumor known for its propensity for early metastasis and poor prognosis. CAS frequency is around 1-2% of all angiosarcoma cases and mostly arise in the right atrium. At present, there are no effective treatments and the survival rate is less than 10% at 5 years. Furthermore, the dearth of preclinical models has limited the advancement of biological insights into CAS. To address this challenge, we developed a somatic mosaic genetically engineered mouse model (smGEMM) with the aim of accurately mirroring the biological features of CAS. This model will be a crucial instrument for acquiring in-depth insights into the disease and steering the development of impactful therapeutic strategies. To develop a CAS smGEMM, we leveraged an endothelial-specific CRE recombinase to activate a fluorescent reporter in a tissue-dependent manner and CRISPR/Cas9 technology to engineer somatic drivers of CAS tumorigenesis. Using this strategy, all endothelial cells express tdTomato fluorescent reporter and spCas9. We then administered adeno-associated viral (AAV) particles carrying selected tandem sgRNAs with two different approaches: a direct approach where AAV particles were administered by ultrasound-guided injection in the cardiac wall of the smGEMM; and an ex-vivo approach where primary endotheliocytes derived from cardiac tissue of our smGEMM were first transduced with AAV particles in vitro, and then transplanted orthotopically by ultrasound-guided injection. With the latter strategy, we successfully generated the first cardiac angiosarcoma model that faithfully recapitulates angiosarcoma features, including lung dissemination. Cell lines from primary and metastatic tumors were also established, characterized and utilized for genome-wide CRISPR Cas9 screening. Current efforts are focused on prioritizing hits for validation, aiming to glean insights that can inform potential therapeutic strategies. Citation Format: Rosalba Minelli, Luigi Perelli, Benjamin J. Bivona, Sanjana Srinivasan, Desiree Catania, Bianca E. Amador, Frederick S. Robinson, Johnathon L. Rose, Christopher T. Terranova, Alejandro Hernandez Martinez, Charles E. Deckard, Courtney N. Le, Kuo-Shun Hsu, Michael Peoples, Aparna Subramaniam, Hannah C. Beird, Ningping Feng, Joseph R. Daniele, Christopher Vellano, Joseph Marszalek, Vinod Ravi, Alexander J. Lazar, Andrew Futreal, Timothy P. Heffernan, Giannicola Genovese, Virginia Giuliani. Development of advanced preclinical modeling for a comprehensive characterization of cardiac angiosarcoma biology [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1447.

Ten-year survival after resection of a huge rhabdomyosarcoma in the pericardial cavity

BackgroundPrimary malignant cardiac tumors are exceedingly rare and cardiac rhabdomyosarcoma among them is an exceptional rarity characterized by a dismal poor prognosis.Case presentationA 48-year-old man had suffered from a persistent cough lasting for more than 6 months and computed tomography showed a huge mass in the pericardial cavity with heterogeneous content. Following referral to our department for suspected cardiac malignancy, cardiac magnetic resonance imaging revealed a lucent layer on the boundary around the mass, suggesting the feasibility of surgical resection. A baby-head-sized mass in the pericardial cavity was entirely resected and the pathological examination confirmed a tumor as a spindle cell type rhabdomyosarcoma. The patient underwent adjuvant chemotherapy and has well survived over a decade after surgery without any sign of recurrence.ConclusionRadical resection with adjuvant chemotherapy may achieve a favorable outcome for patients with massive rhabdomyosarcomas inside the pericardial cavity.

18-F FDG PET/CT in a Case of Recurrent Pericardial Effusion Diagnosed as Cardiac Sarcoma.

Recurrent pericardial effusion poses a diagnostic challenge, especially in young patients. We present a case of a 22-year-old female who experienced recurrent pericardial effusion and cardiac tamponade. Despite initial treatment with anti-tubercular drugs and prednisolone, the patient had a relapse of symptoms, necessitating further investigation. Imaging studies revealed massive pericardial effusion with septations, suggestive of constrictive pericarditis with impending cardiac tamponade. To establish a definitive diagnosis, the patient underwent an FDG PET-CT scan after adhering to a specific dietary regimen. The scan revealed an ill-defined mediastinal mass with high metabolic activity, along with a gross pericardial effusion showing metabolic activity in the periphery and septations. Subsequent biopsy of the mediastinal mass confirmed a diagnosis of high-grade sarcoma.Primary malignant cardiac tumors are rare, and their prognosis is generally poor due to limited treatment options. While echocardiography and MRI are commonly used imaging techniques, FDG PET-CT is not routinely employed for evaluating cardiac tumors. However, in this case, FDG PET-CT played a crucial role in identifying the mediastinal mass and confirming the diagnosis.Early detection and accurate diagnosis of cardiac tumors are vital for initiating appropriate treatment strategies. Further studies are needed to explore the utility of FDG PET-CT in the evaluation of cardiac tumors, especially in cases of recurrent pericardial effusion.

Severe coagulopathy and inflammation occurred after resection of giant right ventricular intimal sarcoma with cardiopulmonary bypass: a case report

BackgroundPrimary malignant cardiac tumors are rare in clinic, and surgical resection under cardiopulmonary bypass (CPB) remains the main treatment. The non-physiological perfusion process of CPB leads to contact activation, and the resulting coagulopathy and systemic inflammatory response syndrome (SIRS) are common complications. However, it is difficult to predict the impact of foreign tumor fragments on this pathophysiological process once they enter the bloodstream, making this phenomenon more complex and challenging.Case PresentationWe report a case of cardiac intimal sarcoma who developed severe coagulopathy and widespread inflammation after excision of massive right ventricular tumor and replacement of tricuspid valve by median sternotomy under CPB. Although the procedure was expected to cause tumor cell necrosis and precautions were taken, uncontrolled massive postoperative bleeding, persistent fever, abnormally elevated inflammatory markers, and recurrent malignant arrhythmias occurred after surgery. In addition to common factors, the most possible underlying mechanism is contact activation triggered following surgical procedure for intimal sarcoma with CPB.ConclusionPatients with intracardiac malignant tumors are at a high risk for serious contact activation during CPB. Preventive application of comprehensive anti-inflammatory measures such as drugs and adsorptive CPB technology, as well as point-of-care (POC) monitoring of coagulation status will be helpful for individualized guidance and optimization of CPB management, and improvement of patient prognosis.

A monster into the heart: an unusual presentation of cardiac leiomyosarcoma

BackgroundMalignant primary cardiac tumors are infrequent and can lead to an unfavorable prognosis if not identified and treated promptly. Early detection and prompt treatment of malignant primary cardiac tumors are crucial for a better prognosis. This article presents a case of primary cardiac leiomyosarcoma and reviews the literature on this topic.Case presentationFemale patient that developed recurrent pericardial effusion and hemodynamic instability caused by a cardiac tumor, later identified as leiomyosarcoma. Multidisciplinary treatment was administered to the patient.ConclusionsThe initial approach to this type of pathology should include multimodality imaging to establish a prompt diagnosis leading to complete standard treatment, to minimize risks to the patient's heart function which may include resection with complete margins of the neoplasm, otherwise the prognosis may be poor.

Abstract 17857: Demographic Disparities and Survival Outcomes in Primary Cardiac Tumors

Introduction: Secondary cardiac tumors are not uncommon as they are seen in almost 14% of patients with multiple distant metastases, the most common primaries being lung, breast, and hematological malignancies. Whereas, primary cardiac tumors are rare, and only about 10-25% of these are primary malignant cardiac tumors (PMCT). With this study, we aim to analyze the demographic disparities and the determinants of survival in this infrequent group of cardiac neoplasms. Methods: We obtained data from the Surveillance, Epidemiology, and End Results (SEER) database, 17 registries, Nov 2022 sub (2000-2020) for PMCT. A total of 713 samples were obtained after excluding patients with unknown age, race, and survival. Cox proportional hazard regression was used for multivariate survival analysis. Results: The mean age at diagnosis of PMCT was 55.13 ± 20.47 years, with the standard deviation reflecting a wide range and dispersion. Males accounted for 51.75% of the patients. Racial demographics showed a predominance of White (61%), followed by Hispanic (18.65%), Asian/pacific islander (10.09%), and Black (9.67%) populations. The most predominant types were sarcomas (62.27%) and lymphomas (27.48 %), with the rest 10.23% including tumors like mesothelioma and adenocarcinoma among others. Kaplan-Meier method was used to estimate overall survival (OS) at 1, 3 and 5 years to be 50.8%, 26.6% and 18% respectively. Cox regression demonstrated statistically significant differences in survival only with age and histopathology. Older patients [HR 1.008 (1.004-1.012)] had worse OS. Compared to sarcomas, lymphomas [HR 0.45 (0.36-0.55)] had better OS, while the group comprising the other 10.23% of PMCTs [HR 1.52 (1.17-1.96)] had worse OS. No statistically significant differences in survival were noted between males and females, and also between different racial groups. Conclusions: Despite being rare malignancies, PMCTs continue to have a poor prognosis. Though sex and ethnicity do not influence survival, older patients with sarcomas and other rare PMCTs have poorer outcomes. Further investigations aimed at improving survival in these at-risk groups are warranted. This information will also aid providers in advanced care planning.

High Risk of Heart Tumors after COVID-19.

A comparative analysis of 173 heart tumors was conducted between 2016 and 2023. Immunohistochemical examination with antibodies against spike SARS-CoV-2 was performed on 21 heart tumors: 10 myxomas operated before 2020 (the control group), four cardiac myxomas, one proliferating myxoma, three papillary fibroelastomas, two myxofibrosarcomas, one chondrosarcoma resected in 2022-2023. Immunohistochemical analysis with antibodies against CD34 and CD68 was also conducted on the same 11 Post-COVID period heart tumors. Immunofluorescent examination with a cocktail of antibodies against spike SARS-CoV-2/CD34 and spike SARS-CoV-2/CD68 was performed in 2 cases out of 11 (proliferating myxoma and classic myxoma). A 1.5-fold increase in the number of heart tumors by 2023 was observed, with a statistically significant increase in the number of myxomas. There was no correlation with vaccination, and no significant differences were found between patients from 2016-2019 and 2021-2023 in terms of gender, age, and cardiac rhythm dis-orders. Morphological examination revealed the expression of spike SARS-CoV-2 in tumor cells, endothelial cells, and macrophages in 10 out of 11 heart tumors. The detection of SARS-CoV-2 persistence in endothelium and macrophages as well as in tumor cells of benign and malignant cardiac neoplasms, the increase in the number of these tumors, especially cardiac myxomas, after the pandemic by 2023 may indicate a trend toward an increased risk of cardiac neoplasms in COVID-19 patients, which re-quires further research on this issue and a search for new evidence.

Rare Case Report: Left Atrial Sarcoma Obstructing the Left Ventricular Inflow.

Malignant cardiac tumors of the heart are extremely rare and may present tremendous diagnostic and therapeutic challenges. These tumors are able to infiltrate the heart and metastasize systemically. Early detection is often elusive as the clinical presentation is highly variable, posing significant diagnostic and therapeutic difficulties. Despite a multidisciplinary approach, the prognosis for patients with malignant cardiac tumors remains guarded. Early diagnosis and a multidisciplinary approach involving cardiac surgeons, oncologists and critical care specialists are crucial in the management of this disease. Further research is needed to better understand the pathomechanisms of tumor-related complications and to develop effective treatment strategies to improve patient outcomes. The rare case of a 78-year-old woman with left atrial tumor requiring emergency surgery for acutely developing mitral valve obstruction is presented. Pathology confirmed an undifferentiated pleomorphic sarcoma. This patient tragically did not survive, highlighting the difficulties of managing such a rare and deceptive heart disease.

Reduced Risk of All-Cause, Cancer-, and Cardiovascular Disease-Related Mortality among Patients with Primary Malignant Cardiac Tumors Receiving Chemotherapy in the United States.

Primary malignant cardiac tumors (PMCTs) are rare but lethal neoplasms. There are limited evidence-based treatment guidelines for PMCTs. We evaluated the relation of chemotherapy with mortality outcomes in patients with PMCTs in the United States. Data were from patients aged ≥ 20 years from the Surveillance, Epidemiology, and End Results program who were diagnosed with PMCTs from 2000 to 2020. Cox regression, competing risk, and propensity score analyses were performed to estimate hazard ratios (HR) and confidence intervals (CI). About 53% of the 563 patients with PMCTs received chemotherapy as the first course of treatment. During a mean follow-up of 24.7 months (median: 10), 458 deaths occurred with 81.7% and 9.4% due to cancer and cardiovascular disease (CVD), respectively. In models adjusted for sociodemographic and clinico-pathophysiological factors including histology, receipt of chemotherapy was associated with low risk for all-cause (HR: 0.56, 95%CI: 0.45-0.69), cancer (HR: 0.63, 95%CI: 0.50-0.80) and CVD mortality (HR: 0.27, 95%CI: 0.12-0.58). Patients who had both chemotherapy and surgery had the lowest risk for all-cause and cancer mortality. This study suggests that the subpopulations of patients with PMCTs who receive chemotherapy may have better prognosis than those who do not receive this therapy regardless of histology.

Malignant cardiac neoplasms and associated malignancies over 16 years in the USA

BackgroundMalignant cardiac neoplasms (MCNs), both primary and metastatic, are rare with few epidemiologic studies. MethodsThis retrospective study used the Healthcare Utilization Project/Nationwide Inpatient Sample database from 2002 to 2018 to evaluate the co-occurrences with other malignancies, and mortality of MCNs in the USA. ResultsThe data contained 7207 weighted discharges of MCN. Median patient age was 51.4 years, 52.29 % were male, in-hospital mortality was 10.51 %, mean cost of hospitalization was $34,280 USD. Lung, mediastinum, and airways were the most common primary cancers associated with metastatic MCN. ConclusionsMCN are rare in the USA, however they carry a high in-hospital mortality, high morbidity, and hospital cost.

Survival and analysis of prognostic factors for primary malignant cardiac tumors based on the SEER database.

The purpose of this study was to use the Surveillance, Epidemiology, and End Results (SEER) database to evaluate the survival rate of primary malignant cardiac tumors (PMCTs), assess the risk factors affecting survival, and calculate the number of PMCT cases in recent years. SEER 22 registries were used to calculate the number of cases PMCT. Data on age, sex, race, marital status, tumor size, the American Joint Committee on Cancer (AJCC) stage, lymph node involvement, metastasis, treatment, and survival were collected to analyze the survival and prognostic factors of SEER 17 registries. Using the Kaplan-Meier estimation method, a survival curve was obtained according to the influencing factors, and a multivariable Cox regression model was established. In recent years, the average annual number of PMCT cases was 20.56 ± 7.12, significantly higher than the average before 2004 (P = 0.015; 95% CI 1.14-8.98). The 1-, 3-, and 5-year survival rates were 45.6%, 18.8%, and 11.2%, respectively. Multivariate analysis revealed that age (risk ratio [HR], 2.047; 95% CI 1.381-3.034), AJCC stage III (HR, 1.786; 95% CI 1.123-2.839), AJCC staging with distant metastasis (HR, 2.666; 95% CI 1.509-4.709), no chemotherapy (HR, 2.011; 95% CI 1.561-2.590), and tumor size larger than 99mm (HR, 1.766; 95% CI 1.132-2.756) were independent risk factors for poor prognosis. Only age over 76years and distant metastasis were independent risk factors for prognosis in the chemotherapy group. In recent years, the annual number of patients with PMCT has increased significantly. Due to developments in chemotherapy, we should re-evaluate the traditional tumor staging and prognostic risk indicators to improve clinical applications.