Primary cardiac tumors on the verge of oblivion: a European experience over 15 years.
BACKGROUND
Primary tumors of the heart represent an exceedingly rare entity in cardiac surgery and literature regarding management and outcome is rare. The aim of this study was to translate 15 years of experience in both multimodal diagnosis and surgical treatment of one of the largest collective of patients in literature into a detailed analysis of patient prognosis, mean survival and best treatment approach.


RESULTS
All patients who underwent open-heart surgery at the Hospital of the Medical University of Vienna for primary cardiac tumor excision between 1999 and 2014 were analyzed retrospectively. Mean follow-up was 76.8 months. Descriptive statistical measurements were applied. 113 patients were identified, 71 (62.8%) female and 42 (37.2%) male patients with a mean age of 57.9 ± 16.8 years. 90.3% (n = 102) masses were benign, 9.7% (n = 11) were malignant. Complete resection was possible for 99% and for 18.2% of benign and malignant masses, respectively. 2.9% of benign tumors and 45.5% of malignant tumors relapsed. The 30-day mortality was 1.8% (n = 2). Mean survival was 187.2 ± 2.7 months and 26.2 ± 9.8 months for benign and malignant pathologies, respectively. Sarcoma patients who underwent adjuvant combination-chemotherapy or adjuvant mono-chemotherapy and radiation had a statistically significant survival advantage of 41.5 months.


CONCLUSIONS
Primary cardiac tumors remain challenging in the clinical setting. A multimodality treatment approach especially for sarcoma patients prolongs mean survival and should be regarded as the standard of care.
Department of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria. andreas.habertheuer@meduniwien.ac.at.
Andreas
A
Habertheuer
Department of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria. guenther.laufer@meduniwien.ac.at.
Günther
G
Laufer
Department of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria. dominik.wiedemann@meduniwien.ac.at.
Dominik
D
Wiedemann
Department of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria. martin.andreas@meduniwien.ac.at.
Martin
M
Andreas
Department of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria. marek.ehrlich@meduniwien.ac.at.
Marek
M
Ehrlich
Department of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria. claus.rath@meduniwien.ac.at.
Claus
C
Rath
Department of Cardiac Surgery, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria. alfred.kocher@meduniwien.ac.at.
Alfred
A
Kocher
D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures; D059186:Chemoradiotherapy, Adjuvant; D015331:Cohort Studies; D005260:Female; D006338:Heart Neoplasms / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000401:mortality / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D012509:Sarcoma / Q000401:mortality / Q000601:surgery*