title: Surgery for primary cardiac tumors in children: early and late results in a multicenter European Congenital Heart Surgeons Association study.
abstract: BACKGROUND
  To evaluate indications and results of surgery for primary cardiac tumors in children.
  
  
  RESULTS
  Eighty-nine patients aged ≤18 years undergoing surgery for cardiac tumor between 1990 and 2005 from 16 centers were included retrospectively (M/F=41/48; median age 4.3 months, range 1 day to 18 years). Sixty-three patients (68.5%) presented with symptoms. Surgery consisted of complete resection in 62 (69.7%) patients, partial resection in 21 (23.6%), and cardiac transplant in 4 (4.5%). Most frequent histotypes (93.2%) were benign (rhabdomyoma, myxoma, teratoma, fibroma, and hemangioma). Postoperative complications occurred in 29.9%. Early and late mortality were 4.5% each (mean follow-up, 6.3±4.4 years); major adverse events occurred in 28.2% of the patients; 90.7% of patients are in New York Heart Association class I. There were no statistically significant differences in survival, postoperative complications, or adverse events after complete and partial resection in benign tumors other than myxomas. Cardiac transplant was associated significantly with higher mortality rate (P=0.006). Overall mortality was associated to malignancy (P=0.0008), and adverse events during follow-up (P=0.005).
  
  
  CONCLUSIONS
  Surgery for primary cardiac tumors in children has good early and long-term outcomes, with low recurrence rate. Rhabdomyomas are the most frequent surgical histotypes. Malignant tumors negatively affect early and late survival. Heart transplant is indicated when conservative surgery is not feasible. Lack of recurrence after partial resection of benign cardiac tumors indicates that a less risky tumor debulking is effective for a subset of histotypes such as rhabdomyomas and fibromas.
authors.affiliation: UOC Cardiochirurgia Pediatrica e Cardiopatie Congenite, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova Medical School, Centro Vincenzo Gallucci, Via Giustiniani 2, 35128 Padova, Italy. massimo.padalino@unipd.it
authors.forename: Massimo A
authors.initials: MA
authors.lastname: Padalino
authors.forename: Vladimiro L
authors.initials: VL
authors.lastname: Vida
authors.forename: Giovanna
authors.initials: G
authors.lastname: Boccuzzo
authors.forename: Marco
authors.initials: M
authors.lastname: Tonello
authors.forename: George E
authors.initials: GE
authors.lastname: Sarris
authors.forename: Hakan
authors.initials: H
authors.lastname: Berggren
authors.forename: Juan V
authors.initials: JV
authors.lastname: Comas
authors.forename: Duccio
authors.initials: D
authors.lastname: Di Carlo
authors.forename: Roberto M
authors.initials: RM
authors.lastname: Di Donato
authors.forename: Tjark
authors.initials: T
authors.lastname: Ebels
authors.forename: Viktor
authors.initials: V
authors.lastname: Hraska
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Jacobs
authors.forename: J William
authors.initials: JW
authors.lastname: Gaynor
authors.forename: Dominique
authors.initials: D
authors.lastname: Metras
authors.forename: Rene
authors.initials: R
authors.lastname: Pretre
authors.forename: Marco
authors.initials: M
authors.lastname: Pozzi
authors.forename: Jean
authors.initials: J
authors.lastname: Rubay
authors.forename: Heikki
authors.initials: H
authors.lastname: Sairanen
authors.forename: Christian
authors.initials: C
authors.lastname: Schreiber
authors.forename: Bohdan
authors.initials: B
authors.lastname: Maruszewski
authors.forename: Cristina
authors.initials: C
authors.lastname: Basso
authors.forename: Giovanni
authors.initials: G
authors.lastname: Stellin
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery; D006338:Heart Neoplasms / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010820:Physicians; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality*; D011296:Prenatal Diagnosis / Q000639:trends; D011300:Preoperative Care / Q000639:trends*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome