AUTHOR=Guan Tianwang , Wei Qingqian , Tang Yongshi , Zhao Hongjun , Lu Zhenxing , Feng Weijing , Teng Yintong , Luo Zehao , Chi Kaiyi , Ou Caiwen , Chen Minsheng TITLE=Metastatic patterns and prognosis of patients with primary malignant cardiac tumor JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=9 YEAR=2022 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.1009765 DOI=10.3389/fcvm.2022.1009765 ISSN=2297-055X 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.