Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2013 May;28(5):717-24. doi: 10.3346/jkms.2013.28.5.717. Epub 2013 May 2.
This study aimed to investigate the clinical implication of surgical resection for the malignancies of heart and great vessels. Between January 2001 and May 2011, a retrospective review of the results in 12 patients was conducted. There were 6 patients with primary cardiac tumor including leiomyosarcoma, angiosarcoma, undifferentiated type sarcoma and malignant fibrous histiocytoma. The remaining 6 patients had the metastatic tumors or adjacent invasion to the heart and great vessels. Six of seven patients who underwent complete resection had no evidence of recurrence. However, four of five patients who underwent incomplete resection or biopsy showed local recurrence or distant metastasis of residual tumor, and one of them required reoperation for recurred tumor. In-hospital mortality was 8.3% and the mean survival of all patients was 22.2 ± 6.1 months. Survival of the incomplete resection group, except for the two biopsy cases, was 25.9 ± 7.9 months, and there was no mortality in the complete resection group. Therefore, clinical outcomes in patients who had malignancies of the heart and great vessels may be improved when the aggressive and complete resection, or possible debulking for palliation, was performed. Moreover, adjuvant multimodality therapy may be imperative to prevent recurrence or metastasis, and to provide improved survival.
本研究旨在探讨心脏和大血管恶性肿瘤手术切除的临床意义。2001 年 1 月至 2011 年 5 月,对 12 例患者的结果进行了回顾性分析。其中 6 例为原发性心脏肿瘤,包括平滑肌肉瘤、血管肉瘤、未分化型肉瘤和恶性纤维组织细胞瘤。其余 6 例患者为转移性肿瘤或邻近心脏和大血管侵犯。7 例完全切除的患者中,有 6 例无复发证据。然而,5 例不完全切除或活检的患者中,有 4 例出现肿瘤残留局部复发或远处转移,其中 1 例因复发性肿瘤再次手术。院内死亡率为 8.3%,所有患者的平均生存时间为 22.2±6.1 个月。除 2 例活检病例外,不完全切除组的生存时间为 25.9±7.9 个月,完全切除组无死亡病例。因此,对于患有心脏和大血管恶性肿瘤的患者,当进行积极的完全切除或可能的姑息性减瘤术时,可能会改善临床结果。此外,辅助多模式治疗对于预防复发或转移,以及提高生存率可能至关重要。