Surgically Resected Cardiac Angiosarcoma: Survival Analysis from the National Cancer Database
Key result
Surgery plus other therapies for cardiac angiosarcoma is linked to ~14 months longer survival vs surgery alone.
- P=0.018
- n=130
Why the study?
The authors sought to investigate the role of surgery in cardiac angiosarcoma, identify late mortality predictors, and evaluate interactions with other treatment modalities using a national dataset.
Does surgery combined with other modalities improve overall survival compared to surgery alone in patients with primary cardiac angiosarcoma?
Population
130 patients with primary cardiac angiosarcoma undergoing surgery from the National Cancer Database
Comparison
Surgery in combination with other modalities vs surgery alone
Design
Retrospective database cohort study
Follow-up
Median 72.02 months
Authors
Discussion
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Implication
Multimodal therapy may extend survival after surgery for cardiac angiosarcoma; this Level 5 analysis leaves open the need for prospective trials.
Key Points
- To evaluate survival outcomes following surgical resection for primary cardiac angiosarcoma and identify independent predictors of late mortality.
- Retrospective review of the National Cancer Database (2004–2017) identifying 130 patients who underwent surgery for primary cardiac angiosarcoma (median age 50.5 years; 36.9% female).
- Survival outcomes and late mortality predictors assessed using Kaplan–Meier analysis and multivariable Cox proportional hazards regression.
- Across a median follow-up of 72.02 months, median overall survival was 14.32 months overall, but reached 17.28 months with multimodal therapy compared to 2.88 months with surgery alone (log-rank p = 0.018).
- Patients older than 57 years experienced significantly lower overall survival than younger patients (log-rank p = 0.012), receiving less surgery (p = 0.037) and chemotherapy (p < 0.001).
- Multivariable Cox regression confirmed that older age and race other than white or black were significant independent predictors of late mortality.
Study Design
Type
Cohort (n=130)
Multicenter
Yes
Structured PICO
Does surgery combined with other modalities improve overall survival compared to surgery alone in patients with primary cardiac angiosarcoma?
P
Population
130 patients with primary cardiac angiosarcoma who underwent surgery, with a median follow-up of 72.02 months.
E
Exposure
Surgery in combination with other therapeutic modalities (e.g., chemotherapy).
C
Comparator
Surgery alone.
O
Outcome
Overall survival (OS) and late mortality predictors.hard clinical
Main Result
Absolute Event Rate: 17.28% vs 2.88%
p-value: p=0.018
In patients with primary cardiac angiosarcoma, combining surgery with other therapeutic modalities significantly improves overall survival compared to surgery alone.
Cite This Study
Rahouma et al. (2023) conducted a cohort in Primary cardiac angiosarcoma (n=130). Surgery in combination with other modalities vs. Surgery alone was evaluated on Median overall survival (months) (p=0.018). Surgery combined with other modalities for primary cardiac angiosarcoma was associated with a significantly longer median overall survival compared to surgery alone (17.28 vs 2.88 months, p=0.018).