TY - JOUR
T1 - Survival outcomes in patients with primary cardiac sarcoma in the United States
AU - Yin, Kanhua
AU - Luo, Rongkui
AU - Wei, Yaguang
AU - Wang, Fenglei
AU - Zhang, Yiwen
AU - Karlson, Karl J.
AU - Zhang, Zhiqi
AU - Reardon, Michael J.
AU - Dobrilovic, Nikola
N1 - Funding Information:
The authors would like to thank Drs Murray Mittleman and Marcia Testa, faculty of the MPH Program in Quantitative Methods, Harvard T.H. Chan School of Public Health, for their advice and assistance during Dr Kanhua Yin's MPH practicum project upon which this research is based. The authors also would like to thank Mr Chen Huang for his assistance in preparing the graphical abstract.
Publisher Copyright:
© 2020 The American Association for Thoracic Surgery
PY - 2021/7
Y1 - 2021/7
N2 - Objective: We aim to evaluate the survival outcomes of primary cardiac sarcoma in a US nationwide cancer database. Methods: The Surveillance, Epidemiology, and End Results database was queried to identify patients with primary cardiac sarcoma from 1973 to 2015. Kaplan–Meier analysis and log-rank tests were performed to compare overall survival for subpopulations, stratified on year at diagnosis (dichotomized into 2 periods: 1973-2005 and 2006-2015), pathological types, whether patients were treated with surgery or not, and surgery and chemotherapy combinations. Multivariable Cox regression was performed to estimate the adjusted hazard ratios and 95% confidence intervals of potentially clinically important factors. Results: A total of 442 patients (mean age, 47.2 ± 18.7 years; male 52.0%) were identified. Most patients were white (78.1%) and diagnosed at age 20 to 60 years (70.2%). Angiosarcoma (43.2%) was the most common histologic type. Overall, the median survival was 7 months, and the 1-, 3-, and 5-year survivals were 40.7%, 15.6%, and 9.8%, respectively. Patients who were diagnosed within the recent decade (2006-2015) did not achieve a better overall survival (P =.13). Surgery (adjusted hazard ratio, 0.49; 95% confidence interval, 0.37-0.64; P <.001) and chemotherapy (adjusted hazard ratio, 0.70; 95% confidence interval, 0.54-0.92; P =.009) were independently associated with improved overall survival. Increasing age (adjusted hazard ratio of 5-year increment, 1.07; 95% confidence interval, 1.04-1.11; P <.001) was independently associated with worse survival. Conclusions: At the population level, primary cardiac sarcoma has a poor prognosis. Both surgery and chemotherapy are associated with improved survival, whereas increasing age at diagnosis was associated with worse survival.
AB - Objective: We aim to evaluate the survival outcomes of primary cardiac sarcoma in a US nationwide cancer database. Methods: The Surveillance, Epidemiology, and End Results database was queried to identify patients with primary cardiac sarcoma from 1973 to 2015. Kaplan–Meier analysis and log-rank tests were performed to compare overall survival for subpopulations, stratified on year at diagnosis (dichotomized into 2 periods: 1973-2005 and 2006-2015), pathological types, whether patients were treated with surgery or not, and surgery and chemotherapy combinations. Multivariable Cox regression was performed to estimate the adjusted hazard ratios and 95% confidence intervals of potentially clinically important factors. Results: A total of 442 patients (mean age, 47.2 ± 18.7 years; male 52.0%) were identified. Most patients were white (78.1%) and diagnosed at age 20 to 60 years (70.2%). Angiosarcoma (43.2%) was the most common histologic type. Overall, the median survival was 7 months, and the 1-, 3-, and 5-year survivals were 40.7%, 15.6%, and 9.8%, respectively. Patients who were diagnosed within the recent decade (2006-2015) did not achieve a better overall survival (P =.13). Surgery (adjusted hazard ratio, 0.49; 95% confidence interval, 0.37-0.64; P <.001) and chemotherapy (adjusted hazard ratio, 0.70; 95% confidence interval, 0.54-0.92; P =.009) were independently associated with improved overall survival. Increasing age (adjusted hazard ratio of 5-year increment, 1.07; 95% confidence interval, 1.04-1.11; P <.001) was independently associated with worse survival. Conclusions: At the population level, primary cardiac sarcoma has a poor prognosis. Both surgery and chemotherapy are associated with improved survival, whereas increasing age at diagnosis was associated with worse survival.
KW - SEER
KW - primary cardiac sarcoma
KW - survival
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U2 - 10.1016/j.jtcvs.2019.12.109
DO - 10.1016/j.jtcvs.2019.12.109
M3 - Article
C2 - 32111430
AN - SCOPUS:85079113369
VL - 162
SP - 107-115.e2
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
IS - 1
ER -