Surgical Management of Primary and Metastatic Cardiac Malignancies: A 20-Year Single-Center Experience.

Abstract

Purpose: Malignant cardiac tumors are rare and have a poor prognosis. Surgical resection is performed for symptom relief and survival benefit, but its efficacy is limited. We reviewed our 20-year single-institution experience with primary and metastatic malignant cardiac tumors.

Methods: We retrospectively reviewed 15 patients who underwent resection for histologically confirmed malignant cardiac tumors between 2006 and 2025. Data included tumor characteristics, resection status, and survival outcomes.

Results: Of 15 patients, 7 (46.7%) had primary tumors (most common: angiosarcoma) and 8 (53.3%) had metastatic lesions. The right atrium was the most frequent site (60.0%). Complete (R0) resection was achieved in only 3 cases (20.0%). Median overall survival (OS) for the cohort was 11 months. Patients with angiosarcoma had particularly poor outcomes (median OS: 5 months). One patient with metastatic thymic carcinoma achieved long-term survival (>15 years) following multimodal therapy. Adjuvant therapy was administered in 7 patients (46.7%). No 30-day postoperative mortality occurred.

Conclusion: Surgical resection of malignant cardiac tumors is feasible with acceptable perioperative safety. Although R0 resection is rarely attainable and long-term outcomes remain poor, particularly for high-grade sarcomas, a multimodal approach is essential to optimize outcomes in selected patients.