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美国原发性心脏恶性肿瘤的特征、生存率及发病率和趋势。

Characteristics, survival and incidence rates and trends of primary cardiac malignancies in the United States.

机构信息

Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Faculty of Medicine, Ain Shams University, Cairo, Egypt.

出版信息

Cardiovasc Pathol. 2018 Mar-Apr;33:27-31. doi: 10.1016/j.carpath.2017.12.001. Epub 2017 Dec 28.

Abstract

BACKGROUND

The available literature on the incidence, management and prognosis of primary malignant cardiac tumors [PMCTs] is limited to single-center studies, prone to small sample size and referral bias. We used data from the Surveillance, Epidemiology, and End Results [SEER]-18 registry (between 2000 and 2014) to investigate the distribution, incidence trends and the survival rates of PMCTs.

METHODS

We used SEER*Stat (version 8.3.4) and the National Cancer Institute's Joinpoint Regression software (version 4.5.0.1) to calculate the incidence rates and annual percentage changes [APC] of PMCTs, respectively. We later used SPSS software (version 23) to perform Kaplan-Meier survival tests and covariate-adjusted Cox models.

RESULTS

We identified 497 patients with PMCTs, including angiosarcomas (27.3%) and Non-Hodgkin's lymphomas [NHL] (26.9%). Unlike the incidence rate of NHL (0.108 per 10 person-years) that increased significantly (APC=3.56%, 95% CI, [1.445 to 5.725], P=.003) over the study period, we detected no significant change (APC=1.73%, 95% CI [-3.354 to 7.081], P=.483) in the incidence of cardiac angiosarcomas (0.107 per 10 person-years). Moreover, our analysis showed that the overall survival of NHL is significantly better than angiosarcomas (P<.001). In addition, surgical treatment was associated with a significant improvement (P=.027) in the overall survival of PMCTs.

CONCLUSION

Our analysis showed a significant increase in the incidence of cardiac-NHL over the past 14 years with a significantly better survival than angiosarcomas. To further characterize these rare tumors, future studies should report data on the medical history and diagnostic and treatment modalities in these patients.

摘要

背景

原发性心脏恶性肿瘤(PMCTs)的发病率、处理方法和预后的相关文献仅限于单中心研究,这些研究容易受到样本量小和转诊偏倚的影响。我们利用监测、流行病学和最终结果(SEER)-18 登记处(2000 年至 2014 年)的数据,调查了 PMCTs 的分布、发病率趋势和生存率。

方法

我们使用 SEER*Stat(版本 8.3.4)和美国国家癌症研究所的 Joinpoint 回归软件(版本 4.5.0.1)分别计算 PMCTs 的发病率和年变化百分比(APC)。之后,我们使用 SPSS 软件(版本 23)进行 Kaplan-Meier 生存检验和协变量调整的 Cox 模型分析。

结果

我们共鉴定出 497 例 PMCTs 患者,其中血管肉瘤(27.3%)和非霍奇金淋巴瘤(NHL)(26.9%)较为常见。与 NHL 的发病率(0.108 人年)呈显著增加(APC=3.56%,95%可信区间:[1.445 至 5.725],P=.003)不同,我们未检测到心脏血管肉瘤的发病率(0.107 人年)有显著变化(APC=1.73%,95%可信区间:[-3.354 至 7.081],P=.483)。此外,我们的分析显示,NHL 的总体生存率明显优于血管肉瘤(P<.001)。此外,手术治疗与 PMCTs 的总体生存率显著改善相关(P=.027)。

结论

我们的分析显示,过去 14 年心脏-NHL 的发病率显著增加,且生存率明显优于血管肉瘤。为了进一步描述这些罕见肿瘤的特征,未来的研究应该报告这些患者的病史以及诊断和治疗方式的数据。

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