Survival after radical resection of cardiac sarcomas

We read with great interest the review article from Ganesh Shanmugan about primary cardiac sarcomas, published in the June issue [1]. This review gives an extensive and comprehensive picture about the occurrence, diagnosis, therapy and outcome of primary cardiac sarcomas. However, we did not agree to the prognosis following surgical therapy. While it is obvious clear, that incomplete resection leads to a low survival rate of less than 1 year; we believe that outcome following complete resection is superior to the mentioned 24 months in the text. In 2004, we published our results following radical resection of cardiac sarcomas [2]. Radical resection was often performed by auto-transplantation with reconstruction of the partly large defects with Dacron and PTFE grafts [3,4]. From the 2004 presented patients [2] one died in the meantime, while the other are still alive without any occurrence of metastasis or local tumor recurrence. So far, with this radical approach, we were able to increase the median survival up to 45 months. Even reports of cardiac transplantation with perioperative chemotherapy in patients with sarcomas could only demonstrate a mean survival of 18 months [5]. We believe that a radial surgical approach in patients with primary sarcomas, even in advanced tumor progression stages, is the only therapeutic option for these often young patients.