Background: Heart transplantation is an uncommon treatment for unresectable and non-metastatic primary\ncardiac sarcomas, and the role of it is unclear. This study aims to offer a survival analysis of it.\nMethods: This study consists of 6 patients from our institution and 40 patients identified in a literature search who\nunderwent heart transplantation for non-metastatic primary cardiac sarcomas. Seven patients with unresectable\ncardiac angiosarcoma who received palliative therapies at our institution were included for comparison. All the\nclinicopathologic data were collected, retrospectively reviewed and statistically analyzed.\nResults: Among the 46 patients receiving heart transplantation for primary cardiac sarcomas, the overall median\nsurvival was 16 months (2ââ?¬â??112 months). The most common histologic type receiving heart transplantation was\nangiosarcoma. Its median survival time after heart transplantation (n = 14) was much less than that of other\nhistologic types (n = 31) (9 vs 36 months; P = 0.002), which means it was not different from the median survival of\n8 months for patients (n = 7) receiving palliative therapies (P = 0.768). The patients with grade 2 cardiac sarcomas\n(n = 5) survived much longer after heart transplantations than patients with grade 3 tumors (n = 15) (mean\nsurvival: 85 vs 18 months; P = 0.006). Neoadjuvant or adjuvant chemotherapy didnââ?¬â?¢t provide survival benefits after\nheart transplantation.\nConclusions: Cardiac angiosarcoma seems to be not the proper indication of heart transplantation. The role of\nheart transplantation in other histologic subtypes still remains undefined. Lower grade and less aggressive\nhistologic subtypes benefit more from heart transplantation.
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