The Impact of Surgical Treatment and Radiation Therapy on The Survival Rate of Patients with Primary Cardiac Neoplasms – An Analysis of Cases from the Surveillance, Epidemiology, and End‐Results Registry
Authors: Lodin Daud , Guerra Orleiquis , Zarei Sara 
Published: November 2023

Objective

Cancers that affect the heart are typically from secondary sources, usually arising from the metastasis of tumors originating from the lung or liver. Primary heart neoplasms are rare a form of tumor that primarily affect younger patients, occurring in only 0.3 to 0.7 percent of cardiac tumor cases. These cancers can have a high rate of malignancy (25 percent) and a very low rate of survival, secondary to the treatment options elected. Very little work has been done, however, to examine the efficacy and impact of the treatment options available to patients. This analysis attempts to examine the advantages and disadvantages of non‐pharmacological treatment options in these cases.

Methods

Data was collected using the Surveillance, Epidemiology, and End‐Results Registry (SEER) −18, looking at cardiac tumor cases from 1973 to 2011. Cases were included in this study if diagnosis included primary cardiac neoplasms and if data was complete for therapy type, mortality, and length of survival. SEER Stat and SAS were used for data extraction and processing. Survival times were compared to both radiation therapy and surgical treatment options using t‐test, odds ratio analysis, and p‐values. Multivariate analysis included factors associated with patient characteristics and neoplasm grading.

Results

Of the 7,386,394 cases of cancer, 487 cases of primary heart neoplasms were recorded and included complete survival statistics. Median patient age was 50–54 years of age and was primarily male (54 percent), white (78 percent), and diagnosed after the year 2000 (51 percent). The majority of cases were diagnosed histologically (88 percent) with samples isolated from soft cardiac tissue (69 percent). No significant difference in patient survival time was found for election of radiation therapy (Utilized = 19.3 Months, Not‐Utilized = 21.5 months; p=0.560) versus surgical treatment (Utilized = 24.6 Months, Not‐Utilized = 18.5 months; p=0.062). Of the primary cardiac neoplasm, cases with heart sarcomas that elected for surgery as their treatment choice had a higher survival rate versus those who did not (23.0 versus 9.0 months; p<0.001). These same cases, however, had no significant improvement with radiation treatment (Utilized = 34.2 Months, Not‐Utilized = 30.5 months; p=0.632). Heart sarcoma patients in general had a lower survival rate in comparison to all other forms of primary cardiac neoplasms (16.9 versus 31.3 months; p<0.001). No appreciable significance in mortality prevention was found in all primary cardiac neoplasm cases if their treatment involved surgery (CMLE OR = 1.1; p=0.558) or radiation therapy (CMLE OR=1.2; p=0.545).

Conclusions

Treatment options for patients for patients with primary cardiac neoplasms are either invasive procedures or toxic to their immune system. The results of this study indicate that radiation therapy for treatment of primary cardiac neoplasms show less efficacy in improving overall outcome, while surgical treatments show a stronger effect in improving survival solely in those with cardiac sarcomas. This investigation also shows that SEER data can be used to examine the efficacy of intervention choice on rarer forms of neoplasms.

Support or Funding Information

The authors of this study had no financial conflicts with this study. This study was a self‐funded exploratory analysis, using publicly available data and literature.