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仅0.8%心脏肿瘤为原发恶性肿瘤,5年生存率不足12%!JACC美国癌症数据

2020-05-07 朱朱 中国循环杂志

近期,JACC上刊登的美国全国性癌症数据显示,在所有心脏肿瘤中,仅0.8%为原发性恶性肿瘤。

近期,JACC上刊登的美国全国性癌症数据显示,在所有心脏肿瘤中,仅0.8%为原发性恶性肿瘤。
 
在这些心脏原发性恶性肿瘤中,88.5%为肉瘤,其中大部分是血管肉瘤(占所有原发恶性肿瘤的40.4%)。
 
心脏原发恶性肿瘤患者的30天、1年、5年生存率分别为81.2%、45.3%、11.5%。
 
近六成(59.2%)的心脏原发恶性肿瘤患者接受手术治疗,其中57.7%在手术同时接受化疗、放疗或化放疗。
 
单纯接受手术治疗的患者中,近三成(29.4%)在90天内死亡。
 
在接受手术治疗的患者中,仅26%的肿瘤切缘达到完全切除(R0)状态。这些切缘干净的患者生存率明显高于切缘仍呈阳性的患者。
 
接受手术治疗的患者长期生存率明显高于未手术患者。另外,在Ⅲ期病变患者中,围术期接受化疗的患者生存率较高。
 
述评专家指出,该研究显示,大多数患者比较年轻(平均才53岁),因此需要改善对心脏原发恶性肿瘤的治疗。
 
对于这些患者,首先要提高手术治疗率,并尽量达到R0切除。如果肿瘤不能完全切除,需要采取多学科治疗策略,术后化疗或放疗可能有助于提高治愈率以及改善患者预后。
 
该研究纳入2004~2016年美国全国癌症数据库中的所有实体心脏肿瘤患者,共确诊约10万例心脏肿瘤,其中826例(0.8%)为原发性恶性肿瘤,最终纳入747例患者,其平均年龄为53岁,47.5%为女士。
 
136例原发性心脏恶性肿瘤患者未接受治疗,113例仅接受化疗,20例仅接受放疗。
 
来源:
[1]Long-Term Outcomes of Primary Cardiac Malignancies Multi-Institutional Results From the National Cancer Database. J Am Coll Cardiol, 2020, 75(18): 2338-2347.
[2]Primary Cardiac Malignancies: The Need for a Multidisciplinary Approach and the Role of the Cardio-Oncologist. J Am Coll Cardiol, 2020, 75(18).
DOI: 10.1016/j.jacc.2020.03.046

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    2021-03-31 柳叶一刀
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