Resection of Malignant and Benign Cardiac Tumors: Operative Results and Long-Term Outcomes
Jeremy R. Leonard, Alexandra N. Schwann, Mario Gaudino, Leonard Girardi, Monica Munjal, Christopher Lau, Weill Cornell Medical Center, New York, NY

OBJECTIVE: Cardiac tumors are uncommon, occurring in less than one percent of the population. We examined the indications and outcomes for resection of cardiac tumors at a tertiary center.

METHODS: Institutional data was queried for patients undergoing resection of benign and malignant cardiac tumors from 1996 to 2017. Outcomes were examined and long-term survival was calculated.

RESULTS: Of 180 patients identified, 66.1% had benign tumors and 33.9% malignant (Table 1). The malignant group was more likely to have history of cancer (60.7% v 19.3%; p<0.001) and to present with embolic phenomena (13.1% v 2.5%, p=0.005). The benign group was more likely to present with cardiac symptoms (42.9% v 23%, p=0.008). Benign tumors consisted mainly of myxoma (58%) and fibroelastoma (36.1%). Malignant tumors were mostly carcinoma (47.5%) and sarcoma (37.7%). Operative mortality was 5.3% in the malignant group and 0.8% in the benign group. Results were similar among carcinoma and sarcoma patients. Five-year survival was 86.5% for the benign group and 38.2% for the malignant group (Figure 1). Tumor recurrence was 3.4% in both groups.

CONCLUSIONS: Cardiac tumors can be safely resected in a select group of patients with anatomically resectable lesions. Operative mortality and tumor recurrence are low with complete resection, and long-term survival can be expected in a reasonable number of patients, even in those with malignant lesions.

Table 1. Pre- and Postoperative Data

Data presented as n (%), unless otherwise noted, *<5% missing follow-up information

Data presented as n (%), unless otherwise noted, *<5% missing follow-up information