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Khirurgii

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Year 2017 Vol. 25 No 1

ONCOLOGY

U.U. ANDRUSHCHUK1, Y.P. OSTROVSKY1,2, V.V. ZHARKOV1, A.V. VALENTSIUKEVICH1, L.G. SHESTAKOVA1,2, O.A. YUDINA3, T.V. ILYINA1, S.G. OMELTSCHENKO1, S.A. KURGANOVICH1, A.Z. SMOLENSKY3

SURGICAL TREATMENT OF PATIENTS WITH PRIMARY MALIGNANT TUMORS OF THE HEART

SE "Republican Scientific Practical Centre Cardiology" 1,
SEE "Belarusian Medical Academy of Post-graduate Education" 2,
ME "City Clinical Pathology Bureau" 3,
Minsk,
The Republic of Belarus

Objectives. To evaluate the results of surgical treatment of patients with primary malignant tumors of the heart (PMTH).
Methods. Within the period from 2001 to 2015 11 patients (5 men, 6 women, mean age 50,7±18,1 years) had undergone surgical resection of primary malignant cardiac tumor in RSPC «Cardiology». PMTH was located in the left side of the heart in seven patients, in the right side – in three, in both right and left sides – in one patient.
Results. Three operations of the heart autotransplantation (HA), one orthotopic heart transplantation (OHT), three radical resections of the tumor «in situ» (RRT) and four cytoreductive interventions (CRI) had been performed. Average time of myocardial ischemia was 119,9±20,2 min, artificial circulation – 178,1±31,9 min., average blood loss – 1601,8±367,3 ml. Major hospital complications (MHC) occurred in six patients. Three patients died due to the non-cardiac causes in the hospital period. The observation period was 467,0±100,3 days. Seven patients (one withdrew) died due to disease progression or relapse. Recurrence-free survival was 456,8±103,0 days, the average duration up to the outcome – 357,6±121,6 days. The survival of patients after radical surgeries (RS) – 565,4±112,2 days, discharged from the center, was 2,5 fold higher than in CRI patients 221,0±28,0 days.
Conclusion. Primary malignant tumors of the heart is a rare pathology with almost fatal prognosis, late detectability and unsatisfactory results of treatment. Radical surgeries (RS) – RRT, HA, OHT as a part of a multimodal treatment are considered to be a current therapeutic strategy of PMTH (except lymphoma). MHC-rate and hospital mortality after RS are high. Relapse or disease progression was the cause of death in all patients within the period of observation. Radical operations and in the case of inability of their performance the cytoreductive operations comprising a multimodal therapy can reduce symptoms and prolong life.

Keywords: primary cardiac tumors, surgery, sarcoma, lymphoma, multimodal therapy, recurrence, mortality
p. 60-70 of the original issue
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Address for correspondence:
220036, the Republic of Belarus, Minsk,
Rosa Luxemburg str., 110,
The Republican Scientific and
Practical Center Cardiology, Laboratory
of heart surgery,
Tel: +375 17 2088605
E-mail: heartslight@mail.ru,
Vladimir V. Andruschuk
Information about the authors:
Andrushchuk U.U. PhD, Cardiac surgeon of cardiac surgery unit N2, SE "Republican Scientific Practical Centre Cardiology".
Ostrovsky Y.P. MD, Professor, Academician of NAS of Belarus, Head of department of cardiac surgery, SEE "Belarusian Medical Academy of Post-graduate Education", Chief Freelance cardiac surgeon Ministry of Health of the Republic of Belarus.
Zharkov V.V. MD, Professor, Head of surgical unit of thoracic oncopathology with the group of anesthesiology, SE "Republican Scientific and Practical Center of Oncology and Medical Radiology named after N.N.Alexandrov".
Valentsiukevich A.V. Head of anesthesiology and intensive care unit, SE "Republican Scientific Practical Centre Cardiology".
Shestakova L.G. MD, Head of extracorporeal circulation unit, SE "Republican Scientific Practical Centre Cardiology", lecturer of cardiac surgery department, SEE "Belarusian Medical Academy of Post-graduate Education".
Yudina O.A. PhD, Ass. Professor, Head of general pathology unit N1, ME "City Clinical Pathology Bureau", Ass. Professor of pathologic anatomy department, EE "Belarusian State Medical University".
Ilyina T.V. Head of X-ray unit, SE "Republican Scientific Practical Centre Cardiology".
Omeltschenko S.G. Clinical intern (cardiac surgery), SE "Republican Scientific Practical Centre Cardiology".
Kurganovich S.A. Physician (ultrasound diagnostics), SE "Republican Scientific Practical Centre Cardiology", fellow-worker of heart surgery laboratory.
Smolensky A.Z. Pathologist of general pathology unit N1, ME "City Clinical Pathology Bureau".
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