Awad Ahmed K, Elgenidy Anas, Afifi Ahmed M, Sa Michel Pompeu, Ramlawi Basel
Faculty of Medicine, Ain-Shams University, Cairo, Egypt.
Faculty of Medicine, Cairo University, Cairo, Egypt.
J Card Surg. 2022 Nov;37(11):3961-3963. doi: 10.1111/jocs.16857. Epub 2022 Aug 18.
Representing 10%-25% of the primary cardiac neoplasms, primary malignant cardiac tumors (PMCT) have a poor prognosis, yet with rare incidence. Constituting more than 50% of the PMCT, cardiac sarcoma has increased not only in incidence over the past five decades but also in severity. Patients with PMCTs, especially sarcomas, have the worst prognosis when compared with other cardiac or extracardiac tumors. This retrospective study was performed using SEER*stat software, latest version 8.3.9.2(5) by accessing seer 18 registries plus data (excl AK) Nov 2020 Sub (2000-2018) for standard mortality ratio (SMR). A total of 235 patients were identified of whom 49.4% were females. Most of our patients were Stage 4 (n = 81) and distant in location (n = 92). The most common treatment method was tumor-directed surgery (n = 164), chemotherapy (n = 146), and radiotherapy (n = 55). Furthermore, other associated cancers with cardiac sarcoma were rare, with ten cases with lung and bronchus cancer (SMR: 37.95, 95% confidence interval [CI]: 18.2, 69.8), four with bone and joints (SMR: 1726.05, 95% CI: 470.2, 4419.3). During a 5-year follow-up, 235 patients died primarily due to cardiac sarcoma (n = 182, 77.4%), other cancers (n = 34, 14.4%), and other noncancerous causes (n = 19, 8%), while the noncancerous causes were attributed mainly to cardiovascular diseases (n = 4, 21%, SMR: 4.95, 95% CI: 1.35, 12.67), septicemia (n = 2, 10.5%, SMR: 41.23, 95% CI: 4.99, 148.95).
原发性恶性心脏肿瘤（PMCT）占原发性心脏肿瘤的10%-25%，预后较差，但发病率较低。心脏肉瘤占PMCT的50%以上，在过去五十年中不仅发病率增加，严重程度也有所增加。与其他心脏或心脏外肿瘤相比，PMCT患者，尤其是肉瘤患者的预后最差。本回顾性研究使用SEER*stat软件（最新版本8.3.9.2(5)），通过访问SEER 18个登记处以及2020年11月的补充数据（不包括阿拉斯加，2000-2018年）来计算标准化死亡率（SMR）。共确定了235名患者，其中49.4%为女性。我们的大多数患者处于4期（n = 81）且肿瘤位置较远（n = 92）。最常见的治疗方法是肿瘤靶向手术（n = 164）、化疗（n = 146）和放疗（n = 55）。此外，与心脏肉瘤相关的其他癌症很少见，有10例肺癌和支气管癌（SMR：37.95，95%置信区间[CI]：18.2，69.8），4例骨与关节癌（SMR：1726.05，95% CI：470.2，4419.3）。在5年的随访期间，235名患者主要死于心脏肉瘤（n = 182，77.4%）、其他癌症（n = 34，14.4%）和其他非癌症原因（n = 19，8%），而非癌症原因主要归因于心血管疾病（n = 4，21%，SMR：4.95，95% CI：1.35，12.67）、败血症（n = 2，10.5%，SMR：41.23，95% CI：4.99，148.95）。
