Primary cardiac tumors: Early and late results of surgical treatment in 91patients

Background. Between March 1980 and September 1997, 91 patients underwent ev aluation and treatment for primary cardiac neoplasms. Methods. Tumors were grouped into three categories: atrial myxomas, benign nonmyxomas, and malignant tumors. Survivors were contacted; no one was lost to follow-up. The mean follow-up for this series is 7 +/- 5 years. Results. Eighty-three patients were diagnosed with atrial myxomas (Male/Fem ale: 29/54), average age 55 +/- 13 years. The hospital mortality was 3.6% ( 3/83), the late mortality was 6.5% (5/80). No recurrent myxomas have been i dentified clinically or by echocardiography in any patient. Three patients were diagnosed with benign nonmyxoma tumors. (Male/Female: 2/1), average ag e 64 +/- 8 years. There were no perioperative deaths and 1 patient died 4 y ears postoperatively from fibroma, with no linked causes. No recurrent tumo rs have been identified. Five patients were diagnosed with malignant tumors . (M/F: 1/4), average age 53 +/- 16 years. The hospital mortality was 20% ( 1/5); in 3 patients a redo-operation was necessary after 8, 11, and 12 mont hs because of tumor recurrence. All patients died within 3 years of the fir st operation (mean 13 +/- 14 months). Conclusions. Surgical resection, when possible, is the treatment of choice for all primary cardiac tumors, Patients with benign tumors are probably cu red by resection and in our experience there was no known tumor recurrence. Effective palliation is possible with resection of malignant tumors, but m ore effective adjuvant therapy will be necessary to improve long-term progn osis. (C) 1999 by The Society of Thoracic Surgeons.