Thorac cardiovasc Surg 2019; 67(08): 665-671
DOI: 10.1055/s-0039-1692409
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Prognostic Factors for Long-Term Survival after Surgical Resection of Primary Cardiac Sarcoma

Anas Aboud
1  Department of Cardiac and Thoracic Vascular Surgery, University of Schleswig-Holstein, Lübeck Campus, Lübeck, Germany
,
Kassar Farha
2  Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany
,
Wan Chin Hsieh
3  Department of Cardiovascular Surgery, First Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic
,
Frank Brasch
4  Department of Pathology, Academic Teaching Hospital Bielefeld, Bielefeld, Germany
,
Stephan Ensminger
1  Department of Cardiac and Thoracic Vascular Surgery, University of Schleswig-Holstein, Lübeck Campus, Lübeck, Germany
,
Jan Gummert
2  Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany
,
André Renner
2  Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany
› Author Affiliations
Further Information

Publication History

20 February 2019

29 April 2019

Publication Date:
27 June 2019 (online)

Abstract

Background Primary cardiac sarcoma (CS) is an extremely rare disease. This study aims to identify possible prognostic factors for long-term survival.

Methods A total of 17 consecutive patients who were treated for primary CS between 2003 und 2018 at two cardiac centers were investigated. Clinical data and histological characteristics of the tumors were analyzed. Long-term follow-up of all patients were performed.

Results The median age was 54 years (range: 23–74). The tumors originated from the left side of the heart in nine patients. Histologically, there were four angiosarcomas, three intimal sarcomas, and three synovial sarcomas. One- and 7-year survivals were 81.9 and 18.2%, respectively. Low expression levels of Ki-67 tended to be associated with increased survival (log-rank p = 0.06). Adjuvant chemotherapy but not radiotherapy regardless of existing metastases was associated with significantly increased survival (log-rank p = 0.001).

Conclusion Angiosarcoma was the most common type of CS. The survival of CS patients is poor but prognostic factors, such as Ki-67, may help estimate the course of the disease. Survival could be improved significantly with chemotherapy.