Metastatic patterns and prognosis of patients with primary malignant cardiac tumor

Tianwang Guan; Qingqian Wei; Yongshi Tang; Hongjun Zhao; Zhenxing Lu; Weijing Feng; Yintong Teng; Zehao Luo; Kaiyi Chi; Caiwen Ou; Minsheng Chen

doi:10.3389/fcvm.2022.1009765

Metastatic patterns and prognosis of patients with primary malignant cardiac tumor

Front Cardiovasc Med. 2022 Dec 5:9:1009765. doi: 10.3389/fcvm.2022.1009765. eCollection 2022.

Authors

Tianwang Guan^{1

2}, Qingqian Wei³, Yongshi Tang³, Hongjun Zhao³, Zhenxing Lu^{1

2}, Weijing Feng⁴, Yintong Teng^{1

2}, Zehao Luo³, Kaiyi Chi³, Caiwen Ou^{1

5}, Minsheng Chen^{1

2}

Affiliations

¹ Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
² Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Sino-Japanese Cooperation Platform for Translational Research in Heart Failure, Guangzhou, China.
³ Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou, China.
⁴ State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Lab of Shock and Microcirculation, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
⁵ Dongguan Hospital of Southern Medical University, Southern Medical University, Dongguan, China.

Abstract

Background: Distant metastases are independent negative prognostic factors for patients with primary malignant cardiac tumors (PMCT). This study aims to further investigate metastatic patterns and their prognostic effects in patients with PMCT.

Materials and methods: This multicenter retrospective study included 218 patients with PMCT diagnosed between 2010 and 2017 from Surveillance, Epidemiology, and End Results (SEER) database. Logistic regression was utilized to identify metastatic risk factors. A Chi-square test was performed to assess the metastatic rate. Kaplan-Meier methods and Cox regression analysis were used to analyze the prognostic effects of metastatic patterns.

Results: Sarcoma (p = 0.002) and tumor size¿4 cm (p = 0.006) were independent risk factors of distant metastases in patients with PMCT. Single lung metastasis (about 34%) was the most common of all metastatic patterns, and lung metastases occurred more frequently (17.9%) than bone, liver, and brain. Brain metastases had worst overall survival (OS) and cancer-specific survival (CSS) among other metastases, like lung, bone, liver, and brain (OS: HR = 3.20, 95% CI: 1.02-10.00, p = 0.046; CSS: HR = 3.53, 95% CI: 1.09-11.47, p = 0.036).

Conclusion: Patients with PMCT who had sarcoma or a tumor larger than 4 cm had a higher risk of distant metastases. Lung was the most common metastatic site, and brain metastases had worst survival among others, such as lung, bone, liver, and brain. The results of this study provide insight for early detection, diagnosis, and treatment of distant metastases associated with PMCT.

Keywords: Epidemiology; Surveillance; and End Results (SEER) database; cardio-oncology; distant metastasis; primary malignant cardiac tumor; prognosis.