TY - JOUR
T1 - Angiosarcoma outcomes and prognostic factors
T2 - A 25-year single institution experience
AU - Buehler, Darya
AU - Rice, Stephanie R.
AU - Moody, John S.
AU - Rush, Patrick
AU - Hafez, Gholam Reza
AU - Attia, Steven
AU - Longley, B. Jack
AU - Kozak, Kevin R.
N1 - Publisher Copyright:
Copyright © 2013 by Lippincott Williams & Wilkins.
PY - 2013
Y1 - 2013
N2 - Objective: Angiosarcoma is an aggressive malignancy with endothelial differentiation and notoriously poor prognosis despite aggressive therapy. Limited data are available to guide management decisions. To address this limitation, we present a large retrospective analysis of angiosarcoma patients treated at a single institution over a 25-year period.Methods: To identify factors that impact angiosarcoma outcomes, we reviewed demographic, tumor, and treatment characteristics of angiosarcoma patients evaluated at the University of Wisconsin Hospital between 1987 and 2012.Results: The cohort included 81 patients diagnosed at ages 19 to 90 years (median, 67y). Fifty-five (68%) patients presented with localized disease, whereas 26 (32%) presented with metastases. The primary sites were visceral/deep soft tissue (42%), head and neck/cutaneous (37%), breast (16%), and limbs in the setting of Stewart-Treves (5%). The 5-year overall survival was 40% with a median of 16 months. By univariate analysis, significant adverse predictors of survival included metastases at presentation, visceral/deep soft tissue tumor location, tumor size>5cm, tumor necrosis, and the absence of surgical excision. A trend toward prolonged survival was observed with radiation therapy and for chemotherapy in patients with metastases. Age, sex, and prior radiation showed no correlation with survival.Conclusions: Our large single institution series confirms the poor prognosis of angiosarcoma, supports a central role for surgical excision in management, and highlights the need for novel therapies particularly in patients who present with metastatic disease.
AB - Objective: Angiosarcoma is an aggressive malignancy with endothelial differentiation and notoriously poor prognosis despite aggressive therapy. Limited data are available to guide management decisions. To address this limitation, we present a large retrospective analysis of angiosarcoma patients treated at a single institution over a 25-year period.Methods: To identify factors that impact angiosarcoma outcomes, we reviewed demographic, tumor, and treatment characteristics of angiosarcoma patients evaluated at the University of Wisconsin Hospital between 1987 and 2012.Results: The cohort included 81 patients diagnosed at ages 19 to 90 years (median, 67y). Fifty-five (68%) patients presented with localized disease, whereas 26 (32%) presented with metastases. The primary sites were visceral/deep soft tissue (42%), head and neck/cutaneous (37%), breast (16%), and limbs in the setting of Stewart-Treves (5%). The 5-year overall survival was 40% with a median of 16 months. By univariate analysis, significant adverse predictors of survival included metastases at presentation, visceral/deep soft tissue tumor location, tumor size>5cm, tumor necrosis, and the absence of surgical excision. A trend toward prolonged survival was observed with radiation therapy and for chemotherapy in patients with metastases. Age, sex, and prior radiation showed no correlation with survival.Conclusions: Our large single institution series confirms the poor prognosis of angiosarcoma, supports a central role for surgical excision in management, and highlights the need for novel therapies particularly in patients who present with metastatic disease.
KW - Angiosarcoma
KW - Retrospective study
KW - Sarcoma
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U2 - 10.1097/COC.0b013e31827e4e7b
DO - 10.1097/COC.0b013e31827e4e7b
M3 - Article
C2 - 23428947
AN - SCOPUS:84914707158
SN - 0277-3732
VL - 37
SP - 473
EP - 479
JO - American Journal of Clinical Oncology: Cancer Clinical Trials
JF - American Journal of Clinical Oncology: Cancer Clinical Trials
IS - 5
ER -