What is the role of surgery in the treatment of cardiac sarcoma?

Updated: Jan 17, 2019
  • Author: John H Raaf, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Answer

Cardiac sarcoma is rarely cured, but prolonged survival or significant palliation is possible with surgical resection. [18, 19] Exploration with biopsy yields tissue for histologic diagnosis and assessment of the gross extent of the tumor.

The role of orthotopic heart transplantation for malignant cardiac tumors continues to be debated. [20, 21, 22, 23]  The results of a study analyzing the outcomes of 46 patients who underwent orthotopic heart transplantation for unresectable primary cardiac sarcomas found that median survival time after heart transplantation for patients with angiosarcoma was much less than that of other histologic types (9 vs 36 months; P = 0.002). Additionally, it was similar to the median survival of 8 months for patients with angiosarcoma receiving palliative care (P = 0.768). [24]

Bench surgery (explantation and autotransplantation of the heart) may aid in achieving more complete tumor resection. [25, 26, 27]

Complete or partial excision of primary or metastatic cardiac sarcoma can provide hemodynamic improvement and relief from congestive heart failure. Alternatively, a pericardial window or pericardiectomy may ameliorate symptoms.

Postsurgical adjuvant radiation and chemotherapy have not proven consistently beneficial. However, adjuvant radiation or chemotherapy can be beneficial in ameliorating symptoms and improving quality of life.


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