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Abstract：
BACKGROUND: Primary cardiac sarcomas (PCSs) are an extremely rare and aggressive type of malignancies that have been described only by a limited number of observational studies. This study aimed to evaluate the currently existing evidence comparing surgical to multimodality treatment of PCS.
METHODS: We systematically reviewed Embase, MEDLINE, Cochrane Database, and Google Scholar, from inception to December 2020, for original articles about surgical and multimodality treatment of PCS. The outcomes included were mortality at various time points, resection margin status, and mean estimated survival. The pooled treatment effects were calculated using a random-effects model.
RESULTS: Ten studies including a total of 1570 patients met our inclusion criteria. Surgery was associated with significantly lower mortality when compared to conservative treatment at 1, 2, and 3 years, whereas no significant difference was found at 5 years. Furthermore, multimodality treatment showed significantly lower mortality at 1 year when compared to surgery alone, but not at 2 and 5 years. We found no difference in mortality between angiosarcomas and other PCS subtypes.
CONCLUSIONS: Overall, surgery was found to provide a significant mortality advantage to PCS patients up to 3 years following treatment. Multimodality treatment might be of additional benefit, although only within the first year. Prospective randomized studies are needed to further explore these differences in the treatment of PCS.
METHODS: We systematically reviewed Embase, MEDLINE, Cochrane Database, and Google Scholar, from inception to December 2020, for original articles about surgical and multimodality treatment of PCS. The outcomes included were mortality at various time points, resection margin status, and mean estimated survival. The pooled treatment effects were calculated using a random-effects model.
RESULTS: Ten studies including a total of 1570 patients met our inclusion criteria. Surgery was associated with significantly lower mortality when compared to conservative treatment at 1, 2, and 3 years, whereas no significant difference was found at 5 years. Furthermore, multimodality treatment showed significantly lower mortality at 1 year when compared to surgery alone, but not at 2 and 5 years. We found no difference in mortality between angiosarcomas and other PCS subtypes.
CONCLUSIONS: Overall, surgery was found to provide a significant mortality advantage to PCS patients up to 3 years following treatment. Multimodality treatment might be of additional benefit, although only within the first year. Prospective randomized studies are needed to further explore these differences in the treatment of PCS.
摘要：
背景：原发性心脏肉瘤（PCSs）是一种极其罕见且侵袭性的恶性肿瘤，仅通过有限数量的观察性研究进行了描述。这项研究旨在评估将PCS的手术与多模式治疗进行比较的现有证据。
方法：我们系统地回顾了Embase，MEDLINE,Cochrane数据库,和谷歌学者，从成立到2020年12月，有关PCS手术和多模态治疗的原创文章。结果包括不同时间点的死亡率，切除边缘状态，估计的存活率。使用随机效应模型计算合并的治疗效应。
结果：包括总共1570名患者在内的10项研究符合我们的纳入标准。与1年、2年和3年的保守治疗相比，手术死亡率明显降低。而在5年没有发现显著差异。此外，多模式治疗显示，与单独手术相比，1年死亡率显著降低，但不是在2年和5年。我们发现血管肉瘤和其他PCS亚型之间的死亡率没有差异。
结论：总体而言，研究发现,手术对PCS患者在治疗后3年内具有显著的死亡率优势.多模式治疗可能会有额外的好处，虽然只在第一年内。需要前瞻性随机研究来进一步探索PCS治疗中的这些差异。
方法：我们系统地回顾了Embase，MEDLINE,Cochrane数据库,和谷歌学者，从成立到2020年12月，有关PCS手术和多模态治疗的原创文章。结果包括不同时间点的死亡率，切除边缘状态，估计的存活率。使用随机效应模型计算合并的治疗效应。
结果：包括总共1570名患者在内的10项研究符合我们的纳入标准。与1年、2年和3年的保守治疗相比，手术死亡率明显降低。而在5年没有发现显著差异。此外，多模式治疗显示，与单独手术相比，1年死亡率显著降低，但不是在2年和5年。我们发现血管肉瘤和其他PCS亚型之间的死亡率没有差异。
结论：总体而言，研究发现,手术对PCS患者在治疗后3年内具有显著的死亡率优势.多模式治疗可能会有额外的好处，虽然只在第一年内。需要前瞻性随机研究来进一步探索PCS治疗中的这些差异。
