Annals of Surgical Oncology

, Volume 14, Issue 6, pp 1953–1967

Treatment and Outcome of 82 Patients with Angiosarcoma

Authors

  • John A. Abraham
    • Orthopedic Oncology, Department of OrthopedicsMassachusetts General Hospital
  • Francis J. Hornicek
    • Orthopedic Oncology, Department of OrthopedicsMassachusetts General Hospital
  • Adam M. Kaufman
    • Orthopedic Oncology, Department of OrthopedicsMassachusetts General Hospital
  • David C. Harmon
    • Hematology/Oncology, Department of MedicineMassachusetts General Hospital
  • Dempsey S. Springfield
    • Orthopedic Oncology, Department of OrthopedicsMassachusetts General Hospital
  • Kevin A. Raskin
    • Orthopedic Oncology, Department of OrthopedicsMassachusetts General Hospital
  • Henry J. Mankin
    • Orthopedic Oncology, Department of OrthopedicsMassachusetts General Hospital
  • David G. Kirsch
    • Department of Radiation OncologyMassachusetts General Hospital
  • Andrew E. Rosenberg
    • Department of PathologyMassachusetts General Hospital
  • G. Petur Nielsen
    • Department of PathologyMassachusetts General Hospital
  • Vikram Desphpande
    • Department of PathologyMassachusetts General Hospital
  • Herman D. Suit
    • Department of Radiation OncologyMassachusetts General Hospital
  • Thomas F. DeLaney
    • Department of Radiation OncologyMassachusetts General Hospital
    • Surgical Oncology, Department of SurgeryMassachusetts General Hospital
Bone and Soft Tissue Sarcomas

DOI: 10.1245/s10434-006-9335-y

Cite this article as:
Abraham, J.A., Hornicek, F.J., Kaufman, A.M. et al. Ann Surg Oncol (2007) 14: 1953. doi:10.1245/s10434-006-9335-y

Abstract

Background

Angiosarcomas are an uncommon type of malignancy that are generally thought to behave usually in a locally aggressive fashion; they often metastasize to distant sites.

Methods

Patients with a diagnosis of angiosarcoma treated at our institution between 1980 and 2006 were analyzed for patient demographics, tumor characteristics, multimodality treatment, and outcomes.

Results

A total of 82 patients were divided into those with primary and advanced disease. Overall, the median age was 65 (range, 22–91) years, and 44% of patients were women. Median size of tumors was 3.8 cm, and 76% of tumors were intermediate or high grade. Tumors were located throughout the body: 32 cutaneous, 22 deep soft tissues or organs, 10 radiation or lymphedema field, 8 bone, and 7 nonirradiated breast. Of 46 patients with primary disease, all patients underwent surgical resection, 67% received radiotherapy, and 27% received chemotherapy. Five-year disease-specific survival was 60%, and negative prognostic factors included intermediate or high grade, and tumors arising in a radiated or lymphedema field. Of 36 patients with advanced disease, 36% underwent a palliative operation, 78% received radiation, and 58% received chemotherapy. Median survival was just 7.3 months, and cutaneous tumors predicted a better prognosis compared with other sites.

Conclusions

Primary angiosarcomas treated with aggressive surgical resection and the addition of radiation for close margins or worrisome pathologic features can result in long-term survival in most patients. The role of adjuvant chemotherapy is unclear. Patients with advanced disease have a poor prognosis, but there can be dramatic responses to chemotherapy in a minority of patients.

Keywords

SarcomaAngiosarcomaOutcomeRadiotherapy

Copyright information

© Society of Surgical Oncology 2007