Kavakbasi Erhan, Scheld Hans Heinrich, Kessler Torsten, Sindermann Jürgen R, Kösek Volkan, Tjan T D T, Martens Sven, Hoffmeier Andreas
Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany.
Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Münster, Münster, Germany.
Thorac Cardiovasc Surg. 2018 Nov;66(8):637-644. doi: 10.1055/s-0037-1603790. Epub 2017 Jun 11.
Primary malignant cardiac tumors rarely occur in clinical care. Little is known about the impact of a parameter on postoperative survival.
From May 1991 to May 2014, a total of 24 patients underwent surgical treatment of a primary cardiac sarcoma in our center. We analyzed our clinical database retrospectively for information on patient characteristics and treatment data. The follow-up could be completed to 91.7%.
Angiosarcoma and non-otherwise-specified sarcoma were the most common tumor entities. R0 resection was achieved in most cases. Postoperative mortality within the first 30 days was 20.8% ( = 5). In four of these five cases, postoperative low-output cardiac failure was the leading cause of death. The cumulative survival rate was 77.3% after 30 days, 68.2% after 3 months, 50.0% after 6 months, 45.0% after 12 months, and 18.0% after 24 months. The mean survival time in the whole group was 47.0 months. A low tumor differentiation was associated with low mean survival, but this was not statistically significant. Mean survival of sarcoma was higher after R0 resection. There was no significant rate of survival difference regarding the adjuvant therapy concept.
Extended surgery alone or in combination with chemo- and/or radiotherapy may be successful in certain cases and may offer a satisfactory quality of life. The establishment of a multicenter heart tumor register in Germany is necessary to increase the number of cases in studies, get more remarkable study results, and standardize the diagnosis and therapy.
原发性恶性心脏肿瘤在临床中很少见。关于某一参数对术后生存的影响知之甚少。
1991年5月至2014年5月，本中心共有24例患者接受了原发性心脏肉瘤的手术治疗。我们对临床数据库进行回顾性分析，以获取患者特征和治疗数据的信息。随访完成率可达91.7%。
血管肉瘤和未另作分类的肉瘤是最常见的肿瘤类型。大多数病例实现了R0切除。术后30天内的死亡率为20.8%（n = 5）。在这5例病例中的4例中，术后低心排血量心力衰竭是主要死亡原因。30天后的累积生存率为77.3%，3个月后为68.2%，6个月后为50.0%，12个月后为45.0%，24个月后为18.0%。全组的平均生存时间为47.0个月。肿瘤低分化与平均生存期短相关，但无统计学意义。R0切除术后肉瘤的平均生存期较高。辅助治疗方案的生存率差异无统计学意义。
单纯扩大手术或联合化疗和/或放疗在某些情况下可能成功，并可提供令人满意的生活质量。在德国建立多中心心脏肿瘤登记册对于增加研究病例数量、获得更显著的研究结果以及规范诊断和治疗是必要的。
