Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Cardiovasc Pathol. 2018 Mar-Apr;33:27-31. doi: 10.1016/j.carpath.2017.12.001. Epub 2017 Dec 28.
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.
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.
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.
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.
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。
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。
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)。
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。