Incidence and survival rates of patients with primary malignant cardiac tumors: A SEER based study.

Abstract

e24007 Background: Primary cardiac tumors (PCTs) are rare growths, comprising less than 1% of all cardiac tumors, with cardiac metastases occurring 30-times more frequently. The incidence of primary malignant cardiac tumors (mPCTs) has been observed to be approximately 10% of all PCTs. The majority of available data on PCTs have been obtained from post-mortem analyses. The advent of echocardiography and specialized cardiac radiography has improved characterization of these tumors. Despite technological advancements in cardiac imaging, there are limited studies on the incidence and survival rates of patients with mPCTs. Methods: The Surveillance Epidemiology and End Results (SEER) database was used to identify and characterize patients diagnosed with mPCTs. Data were collected from 17 registries ranging from the years 2000-2021 for patients with one primary tumor originating in the heart. Further characterization of patients including age, race, tumor histopathology codes, and survival time following diagnosis were included in analysis. Kaplan-Meyer curves and logistic regression analyses were used to identify potential differences in survival by subgroups. Results: Analysis of 445 patients, 200 female and 225 male, showed an overall average yearly incidence rate of 20 cases. Overall, there was no statistically significant difference in incidence rates across these years (p = 0.46). The most commonly diagnosed mPCT was hemangiosarcoma (41.65% of cases) followed by sarcoma, not otherwise specified (7.42% of cases), pleomorphic cell sarcoma (6.97% of cases), fibrosarcoma (5.16% of cases), and leiomyosarcoma (4.94% of cases). Of these patients, 21.1% presented with local disease, 24.7% with regional metastases and 31.0% with distant metastases. The average length of survival of those with death attributable to any mPCT (N=390) was 20 months. The median overall survival (OS) for this population was 11 months. There was no statistically significant difference in OS rates between the top five most common mPCT subtypes (p = 0.41). There was no significant difference in OS based on sex (p = 0.77) or race (p = 0.33). There was no statistically significant difference in 6-month, or 1-year, OS rates (62% and 48%; p = 0.25, p = 0.09, respectively) across time. Treatment with chemotherapy, radiation, and both chemoradiation did not have a statistically significant impact on OS rates (p > 0.4 for all treatment modalities). Conclusions: The incidence and OS of patients with mPCTs has remained consistent throughout the years 2000-2021 despite advancements in cardiac imaging. 6-month and 1-year survival rates of patients diagnosed with mPCTs have remained unchanged in this population. Further studies are indicated to determine the factors contributing to a lack of improvement in diagnosis and survival of this population.