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原发性心脏恶性肿瘤:外科治疗的结果

Primary malignant tumors of the heart: Outcomes of the surgical treatment.

作者信息

Pacini Davide, Careddu Lucio, Pantaleo Antonio, Parolari Alessandro, Leone Ornella, Daprati Andrea, Gargiulo Gaetano Domenico, Di Bartolomeo Roberto

机构信息

Cardiac Surgery Department, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

Pediatric Cardiac Surgery and GUCH Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.

出版信息

Asian Cardiovasc Thorac Ann. 2015 Jul;23(6):645-51. doi: 10.1177/0218492315573674. Epub 2015 Feb 18.

Abstract

BACKGROUND

Malignant cardiac tumors are rare and have an extremely poor prognosis even when complete resection is attempted. The aim of this study was to review the experience of primary malignant cardiac tumors in 2 Italian academic hospitals.

METHODS

The hospital records were searched to identify patients with primary malignant cardiac tumors who underwent surgery between January 1979 and December 2012. Secondary cardiac tumors, whether metastatic or invasive, were excluded as were primary sarcomas of the great arteries. Fourteen patients selected from our institution's surgical series were identified. Eleven (78.6%) were men and 3 (21.4%) were women, and the mean age at surgery was 47.4 years.

RESULTS

The most common histological type was angiosarcoma (28.6%). The mean survival was 28.8 ± 28 months and it was better in men than in women (30.5 ± 8.7 vs. 21.1 ± 3.2 months). Patients with a radical resection at the first surgery had a longer survival compared to patients with a partial resection (39.9 ± 23.2 vs. 24 ± 4 months).

CONCLUSIONS

The treatment outcome for patients affected by primary malignant heart tumors remains poor. Aggressive surgery alone does not provide good results in terms of survival rate. A new multidisciplinary approach is mandatory to improve long-term survival.

摘要

背景

恶性心脏肿瘤罕见,即便尝试进行完整切除,预后也极差。本研究旨在回顾两家意大利学术医院中原发性恶性心脏肿瘤的治疗经验。

方法

检索医院记录,以确定1979年1月至2012年12月期间接受手术的原发性恶性心脏肿瘤患者。排除继发性心脏肿瘤,无论其为转移性还是浸润性,同时排除大动脉原发性肉瘤。从我们机构的手术系列中筛选出14例患者。其中11例(78.6%)为男性,3例(21.4%)为女性,手术时的平均年龄为47.4岁。

结果

最常见的组织学类型是血管肉瘤(28.6%)。平均生存期为28.8±28个月,男性患者的生存期优于女性患者(30.5±8.7个月对21.1±3.2个月)。首次手术时进行根治性切除的患者比进行部分切除的患者生存期更长(39.9±23.2个月对24±4个月)。

结论

原发性恶性心脏肿瘤患者的治疗效果仍然很差。仅积极手术在生存率方面并不能取得良好效果。必须采用新的多学科方法来提高长期生存率。

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