Reduced Risk of All-Cause, Cancer-, and Cardiovascular Disease-Related Mortality among Patients with Primary Malignant Cardiac Tumors Receiving Chemotherapy in the United States - PubMed (original) (raw)

Reduced Risk of All-Cause, Cancer-, and Cardiovascular Disease-Related Mortality among Patients with Primary Malignant Cardiac Tumors Receiving Chemotherapy in the United States

Duke Appiah et al. Curr Oncol. 2023.

Abstract

Primary malignant cardiac tumors (PMCTs) are rare but lethal neoplasms. There are limited evidence-based treatment guidelines for PMCTs. We evaluated the relation of chemotherapy with mortality outcomes in patients with PMCTs in the United States. Data were from patients aged ≥ 20 years from the Surveillance, Epidemiology, and End Results program who were diagnosed with PMCTs from 2000 to 2020. Cox regression, competing risk, and propensity score analyses were performed to estimate hazard ratios (HR) and confidence intervals (CI). About 53% of the 563 patients with PMCTs received chemotherapy as the first course of treatment. During a mean follow-up of 24.7 months (median: 10), 458 deaths occurred with 81.7% and 9.4% due to cancer and cardiovascular disease (CVD), respectively. In models adjusted for sociodemographic and clinico-pathophysiological factors including histology, receipt of chemotherapy was associated with low risk for all-cause (HR: 0.56, 95%CI: 0.45-0.69), cancer (HR: 0.63, 95%CI: 0.50-0.80) and CVD mortality (HR: 0.27, 95%CI: 0.12-0.58). Patients who had both chemotherapy and surgery had the lowest risk for all-cause and cancer mortality. This study suggests that the subpopulations of patients with PMCTs who receive chemotherapy may have better prognosis than those who do not receive this therapy regardless of histology.

Keywords: cardiac tumors; cardiovascular disease; chemotherapy; mortality; surgery; survival.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1

Figure 1

Patient selection with exclusion criteria, SEER 2000–2020.

Figure 2

Figure 2

Standardized mortality ratios comparing CVD mortality for patients with primary malignant cardiac tumors to adults in the U.S. general population according to time since diagnosis and receipt of chemotherapy, 2000—2020.

Figure 3

Figure 3

Cumulative incidence curves for all-cause, cancer-, and cardiovascular disease-related deaths among patients with primary malignant cardiac tumors, SEER 2000–2020. The p values for Gray’s test for equality of cumulative incidence functions were <0.01.

Figure 4

Figure 4

The independent and joint association of receipt of chemotherapy and surgery with all-cause and cancer mortality among patients with primary malignant cardiac tumors, SEER 2000–2020.

Figure 5

Figure 5

Absolute standardized differences for baseline covariates comparing treated to untreated patients in the original and the matched sample or after weighting for propensity scores using inverse probability of treatment weights. IPW: inverse probability of treatment weighting.

References

    1. Burke A. Primary malignant cardiac tumors. Semin. Diagn. Pathol. 2008;25:39–46. doi: 10.1053/j.semdp.2007.10.006. -DOI -PubMed
    1. Joshi M., Kumar S., Noshirwani A., Harky A. The Current Management of Cardiac Tumours: A Comprehensive Literature Review. Braz. J. Cardiovasc. Surg. 2020;35:770–780. doi: 10.21470/1678-9741-2019-0199. -DOI -PMC -PubMed
    1. Oliveira G.H., Al-Kindi S.G., Hoimes C., Park S.J. Characteristics and Survival of Malignant Cardiac Tumors: A 40-Year Analysis of >500 Patients. Circulation. 2015;132:2395–2402. doi: 10.1161/CIRCULATIONAHA.115.016418. -DOI -PubMed
    1. Gupta R., Meghrajani V., Desai R., Gupta N. Primary Malignant Cardiac Tumors: A Rare Disease with an Adventurous Journey. J. Am. Heart Assoc. 2020;9:e016032. doi: 10.1161/JAHA.120.016032. -DOI -PMC -PubMed
    1. Aloysius M.M., Shrivastava S., Rojulpote C., Naseer R., Hanif H., Babic M., Gentilezza K., Boruah P.K., Pancholy S. Racial and ethnic characteristics and cancer-specific survival in Primary Malignant Cardiac Tumors. Front. Cardiovasc. Med. 2022;9:961160. doi: 10.3389/fcvm.2022.961160. -DOI -PMC -PubMed

MeSH terms

LinkOut - more resources