Abstract: Objective To compare the clinical outcomes of patients with cardiac cancer undergoing radical resection by laparotomy or thoracotomy. Methods A total of 198 patients with cardiac cancer were selected from January 2014 to December 2017. Among them, 108 patients in the study group received trans-abdominal cancer resection and 90 patients in the control group received trans-thoracic cancer resection. General clinical characteristics, surgery time, intraoperative and postoperative hemorrhage volumes, postoperative complications, lymph nodes resection rate, positive surgical margins, tumor node metastasis （TNM） stages, hospital mortality rate, hospital stay, and 5-year survival were compared between the two groups. Results No significant difference was found in general clinical characteristics （P>0.05）. Compared with the control group, the surgery time, intraoperative and postoperative hemorrhage volumes, postoperative complication rate, lymph nodes resection rate, and hospital stay were superior in the study group （P<0.05）. No difference in positive surgical margin rate was found between the two groups, both with complete resection. There was no significant difference in 5-year survival rate between the two groups （P>0.05）. Conclusion Complications more frequently happen, operative trauma is larger, and 5-year survival is not increased after trans-thoracic cardiac cancer resection, though more esophagus and mediastinal lymph nodes can be removed. Therefore, trans-abdominal cardiac cancer resection is recommended.

Key words: Cardiac cancer, Trans-abdominal operation, Trans-thoracic operation