Prognostic Impacts of Tumor Size on Patients with Primary Cardiac Sarcoma

Abstract Background Primary cardiac sarcoma (PCS) is a deadly disease. The impact of tumor size on prognosis and surgery outcome in PCS patients remains unclear. Here, we evaluate the impact of tumor size on overall survival (OS) and cancer-specific survival (CSS) of PCS patients to provide a reference for the surgical treatment. Methods 261 PCS participants enrolled from 1983 to 2016 were identified from the SEER database. Using the X-tile program, we classified the tumor size into two subgroups: less than or equal to 4.0 cm (≤ 4.0 cm) and greater than 4.0 cm (> 4.0 cm). The Kaplan–Meier method was used to determine OS and CSS. Univariate and multivariate Cox regression analyses were used to identify the independent prognostic impacts of tumor size and surgery in two subgroups (≤ 4.0 cm vs. > 4.0 cm). Results By using 4.0 cm as a cutoff value, tumor size seemed to be an independent prognostic factor for OS (P=0.009) and CSS (P=0.014) of PCS patients. Surgery improved the OS (P=0.017) and CSS (P=0.040) in PCS with tumor size > 4.0 cm but not in PCS with tumor size ≤ 4.0 cm (both P>0.05). Conclusion Tumor size of > 4.0 cm is an independent predictor of poor prognosis, and is associated with the surgical outcome in PCS patients. Surgery significantly improves the prognosis in PCS patients with tumor size > 4.0 cm. Our findings have the potential to assist clinicians to better evaluate the prognosis of PCS patients and develop optimal therapeutic strategies.