Clinical characteristics and surgical outcomes of cardiac myxoma: A meta-analysis of worldwide experience

Eur J Surg Oncol. 2024 Feb;50(2):107940. doi: 10.1016/j.ejso.2023.107940. Epub 2023 Dec 30.

Abstract

Cardiac myxoma is the most common primary cardiac tumor. However, existing literature mainly consists of single-center experiences with limited subjects. This systematic review aimed to provide data on clinical characteristics and surgical outcomes of cardiac myxoma. We performed a thorough literature search on May 23, 2023 on PubMed, ProQuest, ScienceDirect, Scopus, and Web of Science. The inclusion criteria were English full-text, observational studies, and included >20 subjects. From the search, 112 studies with a total of 8150 patients were included in the analysis. The mean age was 51 years (95 % confidence interval [95%CI] = 49.1-52.3), and the majority were females (64.3 % [95 % CI = 62.8-65.8 %]). The most common clinical manifestation was cardiovascular symptoms. Echocardiography can diagnose almost all cases (98.1 % [95 % CI = 95.8-99.6 %]). Cardiac myxoma was mostly prevalent in left atrium (85.3 % [95%CI = 83.3-87 %]) and predominantly with pedunculated morphology (75.6 % [95%CI = 64.1-84.3 %]). Post-tumor excision outcomes were excellent, with an early mortality of 1.27 % (95 % CI = 0.8-1.8 %), late mortality rate of 4.7 (95 % CI = 2.5-7.4) per 1000 person-years, and recurrence rate at 0.5 (95 % CI = 0.0-1.1) per 1000 person-years. Tumor excision is warranted in a timely manner once the cardiac myxoma diagnosis is established.

Keywords: Cancer; Cardiac Tumor; Epidemiology; Mortality; Myxoma; Recurrence.

Publication types

  • Systematic Review
  • Meta-Analysis
  • Review

MeSH terms

  • Echocardiography
  • Female
  • Heart Atria / pathology
  • Heart Atria / surgery
  • Heart Neoplasms* / diagnosis
  • Heart Neoplasms* / epidemiology
  • Heart Neoplasms* / surgery
  • Humans
  • Male
  • Middle Aged
  • Myxoma* / diagnosis
  • Myxoma* / epidemiology
  • Myxoma* / surgery
  • Treatment Outcome