Factors affecting in-hospital mortality and likelihood of undergoing surgical resection in patients with primary cardiac tumors

Isogai, Toshiaki; Yasunaga, Hideo; Matsui, Hiroki; Tanaka, Hiroyuki; Hisagi, Motoyuki; Fushimi, Kiyohide

doi:10.1016/j.jjcc.2016.05.008

Cited by 28 publications

(35 citation statements)

References 33 publications

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“…Sarcoma, which is a malignant neoplasm, is rarely seen and usually has a poor prognosis [11]. In a previous study, only 31.9% of patients with sarcoma underwent effective surgical resection because of advanced-stage tumors, metastatic extracardiac malignancy, and high comorbidity burdens [12]. …”

Section: Discussionmentioning

confidence: 99%

Surgical Experience of Primary Cardiac Tumor: Single-Institution 23-Year Report

Gao

2017

Med Sci Monit

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Background:Primary cardiac tumors are rare but have favorable surgical prognosis. Previous studies have been small series studies with limited surgical approaches. To date, few studies have examined the clinical features associated with different surgical procedures. Material/Methods:In a search of the cardiovascular surgery database of our institution, we retrospectively identified 225 patients who had cardiac tumor resection from January 1993 to May 2016. The patients' clinical characteristics and operation information were reviewed, and the operation parameters, postoperative complications, and short-term prognosis among robotic, mini-thoracotomy, and conventional procedures in our center were compared. Results:A total of 228 operations were performed, including 156 traditional open surgeries (68.4%), 60 robotically assisted neoplasm resections (26.3%), and 12 mini-thoracotomy procedures (5.3%). Among 232 lesions, myxoma (94.8%) was the most common neoplasm, and the remainders were fibroma (1.3%) and lipoma (0.9%). Operative complications occurred in 36 patients (15.8%). Arrhythmia (8.8%) was the first common complication, and delayed mechanical ventilation (4.8%) ranked second. The overall risk of recurrence of myxoma was 2.7%. The cardiopulmonary bypass (CPB) time in the mini-thoracotomy group was longer than in the robotic group (p=0.034) and the conventional group (p=0.002). There were no significant differences in cross clamp time (p=0.266) or complications (p=0.835) among the three groups. The in-hospital survival rate was 100% in all patients. There were no significant differences in main adverse events among the three groups at six-month follow-up (p=0.285). Conclusions:Prognosis for cardiac neoplasm surgical resection is favorable for primary cardiac tumors. The minimally invasive surgery of cardiac tumor resection can be an alternative to conventional operations in selected patients.

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Section: Discussionmentioning

confidence: 99%

Surgical Experience of Primary Cardiac Tumor: Single-Institution 23-Year Report

Gao

2017

Med Sci Monit

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“…Characteristics of the excluded studies are listed in Table 1. Among the 38 studies, there was one registry analysis (Surveillance Epidemiology and End Results database) [7], two multicenter analyses [2, 16] and 35 single surgical center series. Twenty-seven studies performed survival analyses, and we collected the clinical outcome after surgical resection for PMCTs, which remains universally poor.…”

Section: Resultsmentioning

confidence: 99%

“…Malignant neoplasms and primary malignant cardiac tumors usually require multiple modalities of treatment. Based on the literature we have incorporated into this study, complete tumor resection, adjuvant chemo- and/or radiotherapy, palliative strategy, and even heart transplant were included as therapies [16, 37, 38, 43, 45], but the median survival of PMCT patients was less than 1 year, and this finding is consistent with previous studies that have documented survivals periods of 16.5 months and 9.6 months [26, 54]. Randomized clinical trials have not been carried out to determine the optimal therapy for these primary malignancies [12].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of primary cardiac tumor malignancies in retrospective studies over six decades: a systematic review and meta-analysis

Cao

Qin

et al. 2017

Oncotarget

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The incidence of patients diagnosed with primary malignant cardiac tumors (PMCTs) has increased greatly in the past few decades. Whether this rising prevalence is due to overdiagnosis or an increased malignancy rate of primary cardiac tumors (PCTs) remains unclear. Therefore, we performed a systematic review and meta-analysis of published retrospective studies to determine whether the malignancy rate has been increasing over time. Published studies containing relevant data between 1956 and 2014 were evaluated. Two authors searched for all retrospective studies that included patients diagnosed with PCT and PMCT. Two other investigators independently extracted the data, and discrepancies were resolved by consensus. A random-effects meta-analysis model and cumulative meta-analysis model were used to evaluate the pooled prevalence and trend of dynamic change in PCT malignancies. The effects of time, study period and sample size were studied using a logit-linear regression model with robust error variance and a time variable. Thirty-eight studies involving 5,586 patients were analyzed. The pooled prevalence of PMCT among the patients diagnosed with PCT was 9.9% (95% CI, 8.4% to 11.4%) (I2=70%; P< 0.001), and this prevalence has been stable since around 2003. In the regression model, the malignancy odds ratio remained stable from 1975 onward, and no time effect was observed. Our study confirms that PMCT is uncommon, and the prevalence of PCT malignancies remained stable in the past few decades. The clinically observed increase in incidence is unlikely to reflect a true population-level increase in tumorigenesis. This result strongly suggests that the observed increase in incidence of PMCT most likely reflects increased diagnostic detection over time.

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“…У структурі серцевих новоутворень міксоми становлять 80-90 % доброякісних пухлин серця. Питання своєчасної діагностики новоутворень серця і їх адекватного, нерідко екстреного хірургічного лікування залишаються актуальними [3][4][5].…”

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The Questions of Tactics of Surgical Treatment of Primary Heart Tumors

Vitovsky

Isaienko

Онищенко

et al. 2020

ujcvs

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Introduction. In the structure of cardiac neoplasms, myxoma accounts for 80–90% of benign heart tumors. The frequency of diagnosis of primary heart tumors (PHT), of which more than 80% are morphologically benign tumors, ranges from 0.09% to 1.9% of the total number of hospitalized patients. The aim of the study is to identify important issues of diagnosis and tactics of the surgical treatment of primary heart tumors. Material and methods. At the In Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine for the period from January 1, 1969 to January 1, 2019, 962 patients operated due to primary cardiac tumors. The myxomas of heart (MH) founded in 856 (89.0%) patients, of which in 752 (87.8%) cases – MH of left atrium (LA). The right atrial myxomas (RA) were diagnosed in 77 (9.0%) cases, MH in the left (LV) and in the right (RV) ventricles each in 8 (0.9%) cases, respectively. Multicentric tumor growth with the damage of two or three chambers of the heart was found in 11 (1.3%) patients. The age of patients with MH was from 3 to 78 years old (the middle age 47.5 ± 3.4), of which 621 (72.6%) were between 31 and 60 years old. Non-myxomic benign tumors were observed in 37 (3.9%) cases, malignant tumors – in 67 (7.0%) cases. Results and discussion. The III and IV functional classes according to the NYHA classification included 311 (36.3%) and 73 (8.5%) patients, respectively, which in these groups often required urgent surgical treatment. Hospital mortality over the past 19 years was 0% in the surgical treatment of MH, namely, 493 operations performed without lethal outcomes. Conclusions. The accepted tactics of emergency diagnosis and surgical intervention ensures the effectiveness of treatment with MH, as evidenced by the data of long-term results: 574 (78.3%) patients assigned to the NYHA functional class I, and 108 (14.8%) patients to NYHA functional class II. Survival rate up to 20 years was 79.8%.

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Factors affecting in-hospital mortality and likelihood of undergoing surgical resection in patients with primary cardiac tumors

Abstract: Several background factors were associated with prognosis and surgery in patients hospitalized with primary cardiac tumors.

Cited by 28 publications

References 33 publications

Surgical Experience of Primary Cardiac Tumor: Single-Institution 23-Year Report

Surgical Experience of Primary Cardiac Tumor: Single-Institution 23-Year Report

Prevalence of primary cardiac tumor malignancies in retrospective studies over six decades: a systematic review and meta-analysis

The Questions of Tactics of Surgical Treatment of Primary Heart Tumors

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