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原发性恶性心脏肿瘤:单机构经验回顾

Malignant primary cardiac tumors: review of a single institution experience.

作者信息

Simpson Lijo, Kumar Shaji K, Okuno Scott H, Schaff Hartzell V, Porrata Luis F, Buckner Jan C, Moynihan Timothy J

机构信息

Division of Medical Oncology, Mayo Clinic Cancer Center, Mayo Clinic, Rochester, MN 55905, USA.

出版信息

Cancer. 2008 Jun;112(11):2440-6. doi: 10.1002/cncr.23459.

Abstract

BACKGROUND

Primary cardiac sarcomas are uncommon. The authors undertook to review the Mayo Clinic's experience with primary cardiac sarcomas consisting of 34 patients seen over a 32-year period.

METHODS

The patient database at the Mayo Clinic was searched to identify patients with malignant tumors of the heart seen during the 32-year period between 1975 and 2007. Thirty-four patients with primary cardiac sarcomas were identified and their medical records reviewed for details pertaining to presenting symptoms, staging modalities, treatment approaches, and outcomes.

RESULTS

Of the 34 patients, 17 were men and 17 were women. The median age was 44 years. The mean duration of symptoms at the time of diagnosis was 3.6 months. The most common histologic type was angiosarcoma (41%). The median follow-up for the entire group was 12 months (range, 0-61 months). The median survival for those who underwent a complete surgical excision was 17 months compared with 6 months for those in whom a surgical complete remission could not be achieved (P = .01). Patients with angiosarcoma had a lower survival compared with patients with other histologies (5 months vs 17 months; P = .01). The median survival of patients with metastatic disease was 5 months versus 15 months in patients without metastatic disease (P = .03 by the log-rank test).

CONCLUSIONS

Cardiac sarcomas remain a rare but lethal disease. Compared with extracardiac sarcomas, the prognosis for patients with cardiac sarcomas remains very poor. A complete surgical excision should be performed if possible. Innovative treatment strategies are required.

摘要

背景

原发性心脏肉瘤并不常见。作者回顾了梅奥诊所32年间诊治的34例原发性心脏肉瘤患者的情况。

方法

检索梅奥诊所的患者数据库,以确定1975年至2007年这32年间所诊治的心脏恶性肿瘤患者。共识别出34例原发性心脏肉瘤患者,并查阅其病历以获取有关症状表现、分期方式、治疗方法及预后的详细信息。

结果

34例患者中,男性17例,女性17例。中位年龄为44岁。诊断时症状的平均持续时间为3.6个月。最常见的组织学类型是血管肉瘤(41%)。全组的中位随访时间为12个月(范围0 - 61个月)。接受完整手术切除的患者中位生存期为17个月,而无法实现手术完全缓解的患者中位生存期为6个月(P = 0.01)。血管肉瘤患者的生存率低于其他组织学类型的患者(5个月对17个月;P = 0.01)。有转移疾病患者的中位生存期为5个月,无转移疾病患者为15个月(对数秩检验P = 0.03)。

结论

心脏肉瘤仍然是一种罕见但致命的疾病。与心脏外肉瘤相比,心脏肉瘤患者的预后仍然很差。若有可能应进行完整的手术切除。需要创新的治疗策略。

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