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The effect of additional treatments after surgery in patients with primary cardiac sarcoma (PCS) remains unknown. The present study aims to evaluate the benefit of chemotherapy in patients with non-metastatic cardiac sarcomas after optimal resection. Between October 1979 and December 1995, 15 patients with a median age of 45 (range 16-66) and a resected primary cardiac sarcoma [angiosarcoma (six), malignant fibrous histiocytoma (three), leiomyosarcoma (two), rhabdomyosarcoma (two), liposarcoma (one) and synoviosarcoma (one)] received a doxorubicin-containing regimen within 6 weeks of surgery. Adjuvant chemotherapy combinations included cyclophosphamide, vincristine and dacarbazine in four patients; ifosfamide in nine; methotrexate and vincristine in one; and doxorubicin alone in one patient. At present, 13 patients have relapsed (five during therapy), with a median time to progression of 10 months. Twelve patients developed local relapse, in four cases without metastatic disease. Two patients remain in complete remission 27 and 25 months after surgery. The median time to progression was shorter in patients presenting a cardiac angiosarcoma than other histological types (3 vs 14 months, P < 0.01). Twelve patients have died, with a median overall survival of 12 months. The 2-year survival rate is 26%. Survival was significantly longer for patients with completely resected tumours (22 vs 7 months; P = 0.02) and those who did not have angiosarcoma (18 vs 7 months; P = 0.04). In conclusion, post-operative conventional doxorubicin-based chemotherapy failed to modify the natural history of patients with resected cardiac sarcomas. Locoregional failure remains the main problem even after histologically complete resection. New approaches must be tested in patients with primary cardiac sarcoma.

A mesothelioma register was initiated in France in 1975 to record pathologists, cases diagnosed since 1965. These cases have been accepted as definite mesothelioma after histological reexamination by the mesothelioma panel. Histories of asbestos exposure have been recorded using a standardized questionnaire. Among 699 cases reported, 296 were confirmed and 79 excluded by the panel. Twenty per cent of cases were females. Tumour was located in the pleura in 96% of cases. Age at death was lower for the mesothelioma group than for the general population. A linear increase of annual incidence since 1965 has been observed. Mapping of cases showed irregular distribution with areas without any case. Distribution of cases according to asbestos exposure was the following: definite occupational history 50%, definite non-occupational 3%, possible occupational 31%, undiscovered 16%. Distribution of cases according to the latency period showed a two peaks-curve, median being 36 years. The obvious under-reporting of cases and the absence of control group greatly affected the validity of some results.