Division of Cardiac Surgery, Department of Emergency and Organ Transplant, Policlinico Hospital, University of Bari, Bari, Italy.
Department of Cardiovascular Surgery, GVM Care and Research, Anthea Hospital, Bari, Italy.
J Card Surg. 2022 May;37(5):1287-1289. doi: 10.1111/jocs.16358. Epub 2022 Feb 21.
Primary malignant cardiac tumors represent (PMCTs) a very rare disease with an incidence of 0.009% (up to 10% of primary cardiac neoplasms) and are related to a very poor prognosis. The study by Mohamed Rahouma tries to give us information on sex differences in PMCTs, their incidence, behavior, and outcomes. Females were significantly older and had a lower stage of cancer. Males are known to have a more aggressive course and present at an earlier age. Sarcoma is the most common type of PMCTs in both males and females. There was no gender disparity in late mortality and patients who underwent surgery had a better prognosis than those who did not undergo surgery. Significant predictors of late mortality were found to be patients' high comorbidity index, angiosarcoma histology, and Stage III/IV. A challenge for cardiac surgeons is to improve survival in patients with cardiac malignancies, involving a multidisciplinary approach with oncologists, cardiologists, and radiologists. To pave the way for a significant improvement in survival in the future, more advanced sex-specific medical therapies for cancer such as novel chemotherapy agents, targeted immune therapies, genetic engineering need to be standardized to PMCTs and combined with radiological therapies such as gamma-knife and very advanced surgery to effectively treat even very aggressive forms of malignant tumors, with a significant impact on the patient's quality of life and survival.
原发性心脏恶性肿瘤（PMCT）是一种非常罕见的疾病，发病率为 0.009%（占原发性心脏肿瘤的 10%），预后极差。Mohamed Rahouma 的研究试图为我们提供关于 PMCT 中性别差异、发病率、行为和结局的信息。女性明显更年长，癌症分期更低。众所周知，男性的病程更具侵袭性，发病年龄更早。肉瘤是 PMCT 中男性和女性最常见的类型。晚期死亡率在性别间没有差异，接受手术的患者比未接受手术的患者预后更好。晚期死亡率的显著预测因素是患者的高合并症指数、血管肉瘤组织学和 III/IV 期。心脏外科医生面临的挑战是通过多学科方法，包括肿瘤学家、心脏病学家和放射科医生，提高患有心脏恶性肿瘤患者的生存率。为了在未来显著提高生存率，需要将针对癌症的更先进的性别特异性医疗疗法（如新型化疗药物、靶向免疫疗法、基因工程）标准化，并与放射治疗（如伽玛刀和非常先进的手术）相结合，以有效治疗甚至非常侵袭性的恶性肿瘤，从而对患者的生活质量和生存率产生重大影响。
