Abstract:
This study aimed to compare the clinical characteristics and courses of pediatric patients with cardiac tumors in nonoperative and operative groups to help guide treatment decisions. We reviewed the medical records of patients diagnosed with primary pediatric cardiac tumors at our institution between 2003 and 2020. Demographic data, clinical characteristics, and follow-up data between the operation and nonoperation groups were compared. A total of 56 patients were included in the study. Thirteen patients underwent surgery. The median age was 1.4 months (range, 1 to 18 years). The patients in the operation group had more frequent symptoms or signs, such as desaturation, respiratory difficulty, murmur, a higher mass area/chamber area (MC) ratio, decreased ventricular contractility, and significant ventricular outflow tract obstruction (VOTO). An MC ratio of 0.568 was the cutoff value for differentiating patients with symptoms or signs of heart failure and decreased ventricular contractility. At the last follow-up, all patients had good ventricular contractility except one patient in the operative group with fibroma. In the non-operative group, rhabdomyomas often regressed spontaneously, while fibromas often increased in size. Two patients in the nonoperative group died. In the operative group, there was no early or late mortality or tumor recurrence. In this study, patients had good outcomes with or without surgery, even when the tumor was large, or surgery was performed in early infancy.
摘要:
本研究旨在比较非手术组和手术组小儿心脏肿瘤患者的临床特征和病程,以帮助指导治疗决策。我们回顾了2003年至2020年间在我们机构诊断为原发性小儿心脏肿瘤的患者的医疗记录。人口统计数据,临床特征,比较手术组与非手术组的随访数据。共有56名患者被纳入研究。13例患者接受了手术。中位年龄为1.4个月(范围,1至18岁)。手术组患者出现更频繁的症状或体征,比如去饱和,呼吸困难,杂音,较高的质量面积/室面积(MC)比,心室收缩力降低,和显著的心室流出道梗阻(VOTO)。MC比率为0.568是区分具有心力衰竭症状或体征和心室收缩力降低的患者的临界值。在最后一次随访中,除手术组1例纤维瘤患者外,所有患者均有良好的心室收缩力.在非手术组,横纹肌瘤常自发消退,而纤维瘤的大小往往增加。非手术组中有两名患者死亡。在手术组,无早期或晚期死亡或肿瘤复发.在这项研究中,无论手术与否,患者都有良好的预后,即使肿瘤很大,或手术是在婴儿早期进行的。