LAUSR

To the editor, We read with great interest the article by Torabi et al. which discusses outcomes with surgical and multimodality treatment in patients with primary cardiac sarcomas. The authors have done a remarkable job at highlighting posttreatment outcomes in patients with primary cardiac sarcomas. We wish to add to the observations made by the authors and discuss the various factors that affect overall outcomes in patients with primary malignant cardiac tumors (PMCT). It is well known that due to their rarity, the diagnosis and treatment of PMCT continues to pose a significant challenge to clinicians. It has been shown that several factors such as tumor location and size, mitotic count, presence of necrotic regions and presence of metastases impact the overall prognosis of PMCT. However, the impact of age, race, type of malignancy, etc. on overall outcomes has been inadequately studied. The Surveillance, Epidemiology, and End Results Program (SEER) database was interrogated for the current analysis. We used SEER*STAT v8.3.1 (Division of Cancer Control Population Sciences, National Cancer Institute [Calverton, MD] https://seer.cancer.gov) to extract data on PMCTs diagnosed between 1973 and 2016 from the National Cancer Institute's SEER 18 database. Flow chart for patient selection is shown in Figure 1. A race and tumor‐type specific analysis was performed to identify trends in PMCTs. Baseline characteristics and group differences were compared using the Pearson's χ test for proportions. Kaplan–Meier method was used for survival analysis and the log‐rank test for equality of survival functions, including assessing survival differences. Continuous data were analyzed using a t test. Results with p value of less than .05 were deemed statistically significant. All statistical analyses were performed using SAS software v 9.4. We identified a total of 825 patients with PMCT. Out of these, 647 patients were white, 94 patients were black and 84 were others (American Indians, Alaskan natives, Asians, or Pacific Islanders). Mean age at diagnosis for lymphoma was the highest at 65.17 years, followed