Efficacy of Surgical and Non-Surgical Treatments for Primary Cardiac Angiosarcoma

Background: This study aimed to investigate the optimal treatment strategy for primary cardiac angiosarcoma (PCAS) by evaluating the complications and survival outcomes associated with surgical and non-surgical treatment approaches. Methods: A retrospective cohort study was conducted to compare the clinical and pathological data of six patients who underwent surgical treatment (surgical treatment group) with those of five patients who received non-surgical treatment (non-surgical treatment group). These patients were hospitalized at the Department of Oncology, Chongqing University Cancer Hospital, and the Department of Cardiothoracic Surgery, Chongqing Kanghuazhonglian Cardiovascular Disease Hospital, between June 2014 and January 2024. The prognostic outcomes of both groups were analyzed. Results: Among the eleven patients diagnosed with PCAS (five males and six females, with a median age of 42 years), those who underwent surgical intervention exhibited greater improvement in cardiac function and quality of life scores at discharge compared to those who did not undergo surgery. Within 30 days of treatment, two patients died: One in the surgical group due to postoperative bleeding and another due to postoperative low cardiac output syndrome. Another patient from the non-surgical group also died as a result of tumor progression. The median follow-up period was 15 months (range, 2–44 months). The median overall survival (OS) in the surgical cohort was 344 days (range: 32–672), which was significantly shorter than the 458 days (range: 62–1341) observed in the non-surgical group (p < 0.05). Moreover, the median disease-free survival in the surgical group was 306 days (range, 273–672 days), whereas it was 396 days (range, 91–1341 days) in the non-surgical group (p < 0.05). Conclusion: For patients with advanced PCAS, non-surgical comprehensive treatment appears to be a more advantageous therapeutic option.