[Association of tumor cells at the cardiac myxoma stalk invading into the elastic fiber layer between heart walls with tumor recurrence: a preliminary study].

Objective: To analyze the pathological features of recurrent cardiac myxoma to provide a reference basis for clinical treatment and postoperative follow-up. Methods: The pathological data of cardiac myxoma patients who underwent cardiac myxoma surgery in Beijing Anzhen Hospital, Beijing, China from 2002 to 2016 were retrospectively analyzed. According to the grouping criteria, the cases were divided into the recurrence group (n=6) and control group (n=73). Results: In the recurrence group, there were 3 females and 3 males with a median age of 47 years. In the control group, there were 49 females and 24 males, with a median age of 53 years. Cardiac myxoma usually occurred in the left atrium. In the recurrence group, 5 cases occurred in the left atrium and 1 case in the right atrium. In the control group, 68 cases occurred in the left atrium, 4 cases in the right atrium, and 1 case in bilateral atria. Among the 6 cases in the recurrence group, the recurrence time was 1-7 years, with average 4.8 years. In the univariate analysis of recurrent cardiac myxoma pathology, disruption of elastic fiber layer and tumor cells of the tumor stalk invading into the myocardium through the elastic fiber layer were statistically associated with recurrence of cardiac myxoma (P<0.05). Logistic regression analyses showed that the invasion of tumor cells through the elastic fiber layer of the heart wall into the myocardium was an independent risk factor for recurrence (Odds Ratio=0.999, P<0.05). Conclusion: During the pathologic diagnosis, assessing the relationship between tumor cells in the stalk of cardiac myxoma and elastic fiber layer can help estimate the recurrence risk of cardiac myxoma, and thus guide clinical treatment and postoperative follow-up.