Overview

In our meta-analysis of cardiac tumors prevalence and mortality with 8,849 patients from 74 studies, there were 7,484 benign primary cardiac tumors (PCTs), 862 (9.7%) malignant PCTs, and 355 secondary cardiac tumors. The prevalence of malignant PCTs (PMCTs) represent the minority of PCT ( 10%) and have a higher prevalence in Europe and North America. Survival is higher in benign pathology and is significantly improved by treatment in specialized high-volume centers. Approximately 2% of patients with CTs undergo heart transplantation. In another meta-analysis of minimally invasive (MI) approaches of primary cardiac tumors: 11 studies with 653 subjects, we found that both MI and median sternotomy (MS) were associated with excellent early and late outcomes with acceptable survival rates and low incidence of recurrences. In an analysis of the National Cancer Database (NCDB) to assess the sex differences in primary malignant cardiac tumors including 736 PMCTs [median age 52, female (47.8%)]. Most of them were high-grade (49.2%). About 60% underwent surgery. Angiosarcoma (43%), fibrosarcoma (5.2%), and leiomyosarcoma (5.2%) were the most common pathologies. No differences in late mortality between males and females. Surgery and chemotherapy were associated with longer survival benefits. On the contrary, the associated risk factors for mortality were advanced age, higher comorbidity index, angiosarcoma histology, and stage III/IV. Another analysis of NCDB to identify the association between insurance status and survival among patients with malignant cardiac tumors included 699 patients showed that 412 (58.9%) had private insurance, 243 (34.8%) had governmental insurance, and 44 (6.3%) were uninsured. The operative mortality rate was 8.5% (11.1, 2.6, 13.9, and 7% in uninsured, Medicaid, Medicare, and private insurance/managed care groups respectively; P= 0.094). Higher co-morbidity index, angiosarcoma, and stage III-IV cancer were associated with shorter survival, whereas private insurance, recent years of diagnosis, treatment by surgery, and chemotherapy were associated with better survival. Additional analysis of NCDB to identify the short- and long-term mortality outcomes of octogenarians with primary malignant cardiac tumors. Among 736 included patients with a median age was 52 years, there were 72 (9.8%) septuagenarians and 44 (5.98%) octogenarians. The independent predictors of late mortality included octogenarian, governmental insurance, Charlson comorbidity grade II/III, earlier year of diagnosis, angiosarcoma, stage III/IV, and absence of surgery/chemotherapy. Predictors of 30-day mortality among the surgical cohort included octogenarian, and comorbidity grade II/III. Further analysis of NCDB to identify the outcomes of surgery in cardiac angiosarcoma revealed that it was identified in 294 patients. It has poor overall survival. Late years of diagnosis, surgery, and chemotherapy were associated with better survival, while advanced stages were associated with higher mortality among such pathology. While surgery utilization is important, it is not the main utilized modality. Geographic variation in PMCTs and their outcomes: The median overall survival was 11, 21, 13, and 11 months for Midwest, Northeast, South, and West regions respectively. The South region had a significantly higher proportion of black patients, sarcoma, and lower income in comparison to Northeast. While univariate analysis revealed that patients in the south areas had worse survival compared to other geographic areas, geographic disparity in survival was nullified in multivariate analysis. The predictors of late mortality were age (HR 1.016), year of diagnosis (HR 0.974), carcinoma (HR 2.42), sarcoma (HR 3.06), localized and regional stages (HR 0.55, and HR 0.71), surgery (HR 0.64) and chemotherapy (HR 0.59).

Full Product Details

9798223327196

Table of Contents

Reviews

Author Information

Tab Content 6

Customer Reviews

Recent Reviews

Countries Available