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Eur J Cardiothorac Surg 2006;30:953
© 2006 Elsevier Science NL

Letters to the Editor

Survival after radical resection of cardiac sarcomas

Andreas Hoffmeier*, Hans H. Scheld, Stefan Klotz

Department of Thoracic and Cardiovascular Surgery, University Hospital Muenster, Muenster, Germany

Received 7 August 2006; accepted 15 September 2006.

* Corresponding author. Address: Department of Thoracic and Cardiovascular Surgery, University Hospital Muenster, Albert-Schweitzer-Str. 33, 48149 Muenster, Germany. Tel.: +49 251 8347401; fax: +49 251 8348316. (Email: andreas.hoffmeier{at}ukmuenster.de).

Key Words: Cardiac sarcoma • Auto-transplantation • Transplantation • Survival

We read with great interest the review article from Ganesh Shanmugan about primary cardiac sarcomas, published in the June issue [1]. This review gives an extensive and comprehensive picture about the occurrence, diagnosis, therapy and outcome of primary cardiac sarcomas. However, we did not agree to the prognosis following surgical therapy. While it is obvious clear, that incomplete resection leads to a low survival rate of less than 1 year; we believe that outcome following complete resection is superior to the mentioned 24 months in the text.

In 2004, we published our results following radical resection of cardiac sarcomas [2]. Radical resection was often performed by auto-transplantation with reconstruction of the partly large defects with Dacron© and PTFE© grafts [3,4]. From the 2004 presented patients [2] one died in the meantime, while the other are still alive without any occurrence of metastasis or local tumor recurrence. So far, with this radical approach, we were able to increase the median survival up to 45 months. Even reports of cardiac transplantation with perioperative chemotherapy in patients with sarcomas could only demonstrate a mean survival of 18 months [5]. We believe that a radial surgical approach in patients with primary sarcomas, even in advanced tumor progression stages, is the only therapeutic option for these often young patients.

Footnotes

\#9734; The authors of the original paper [1] were invited to comment on this Letter to the Editor but declined the offer.

References

  1. Shanmugam G. Primary cardiac sarcoma. Eur J Cardiothorac Surg 2006;29(6):925-932.[Abstract/Free Full Text]
  2. Hoffmeier A, Deiters S, Schmidt C, Tjan TD, Schmid C, Drees G, Fallenberg EM, Scheld HH. Radical resection of cardiac sarcoma. Thorac Cardiovasc Surg 2004;52(2):77-81.[CrossRef][Medline]
  3. Hoffmeier A, Schmid C, Scheld HH. Reply: "Ex situ resection of primary cardiac tumors". Thorac Cardiovasc Surg 2003;51Hoffmeier A, Schmid C, Scheld HH. Reply: "Ex situ resection of primary cardiac tumors". Thorac Cardiovasc Surg 2004;52(2):125.[CrossRef][Medline]
  4. Hoffmeier A, Schmid C, Deiters S, Drees G, Rothenburger M, Tjan TD, Schmidt C, Loher A, Maintz D, Spieker T, Mesters RM, Scheld HH. Neoplastic heart disease—the Muenster experience with 108 patients. Thorac Cardiovasc Surg 2005;53(1):1-8.[CrossRef][Medline]
  5. Uberfuhr P, Meiser B, Fuchs A, Schulze C, Reichenspurner H, Falk M, Weiss M, Wintersperger B, Issels R, Reichart B. Heart transplantation: an approach to treating primary cardiac sarcoma?. J Heart Lung Transplant 2002;21(10):1135-1139.[CrossRef][Medline]




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