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Incidence and Risk Factor Analysis for Survival in Patients With Primary Cardiac Sarcomas
*Leonidas Tapias, *Luis F Tapias, *Babatunde A Oriowo, *Mandip Joshi, *Robert A Brenes, Juan A Sanchez
St Mary's Hospital. The Stanley J. Dudrick Department of Surgery, Waterbury, CT
Objective:
To analyze the factors affecting long-term survival in patients with primary cardiac sarcomas (PCS).
Design:
Retrospective Cohort
Setting:
Surveillance, Epidemiology, and End-Results (SEER) database (1973-2007; 17 registries)
Patients:
Patients with PCS on the SEER database years 2000-2007
Interventions:
None
Main Outcome Measures:
Incidence; overall and cancer-specific survival
Results:
The overall incidence of primary cardiac tumors was 0.415 (per million), while for PCS it was 0.213. There were 238 patients with PCS during 1973-2007. The median survival for the entire cohort was 8 months. Overall one and five year survival were 38% and 8% and cancer-specific survival were 42% and 10%. Univariate analysis showed that older age (p=0.009), histology (angiosarcoma vs. others; p=0.055), grade of differentiation (poor/undifferentiated vs. well/moderate; p=0.059), invasion of parietal pericardium/adjacent structures (p=0.037) and not undergoing surgery (p<0.001) were most closely associated to decreased overall (p values) and cancer-specific survival. Type of surgery performed (local vs. radical excision) showed no difference (p=0.939). Multivariate analysis showed that older age (p=0.039), differentiation (p=0.014) and no surgery (p=0.016) correlate with a decrease in overall survival and only differentiation (p=0.011) and no surgery (p=0.005) with cancer-specific survival
Conclusions:
PCS are rare neoplasms with a poor prognosis irrespective of histology. Older patients, no surgery, and less differentiated tumors carry a worse prognosis
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