Annals of Surgical Oncology

, Volume 14, Issue 6, pp 1953–1967 | Cite as

Treatment and Outcome of 82 Patients with Angiosarcoma

  • John A. Abraham
  • Francis J. Hornicek
  • Adam M. Kaufman
  • David C. Harmon
  • Dempsey S. Springfield
  • Kevin A. Raskin
  • Henry J. Mankin
  • David G. Kirsch
  • Andrew E. Rosenberg
  • G. Petur Nielsen
  • Vikram Desphpande
  • Herman D. Suit
  • Thomas F. DeLaney
  • Sam S. Yoon
Bone and Soft Tissue Sarcomas

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

Sarcoma Angiosarcoma Outcome Radiotherapy 

Notes

ACKNOWLEDGMENTS

This work was funded by NIH grant 5K12CA87723-03 (S.S.Y.), Kristan Ann Carr Fund (S.S.Y.), and Sarcoma Foundation of America Brian J. Monaghan Memorial Research Award (S.S.Y.). We thank Carol Venuti for help with examining the Massachusetts General Hospital Cancer Data Registry and Wendy Kobayashi for help with examining the Massachusetts General Hospital Radiation Oncology Database.

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Copyright information

© Society of Surgical Oncology 2007

Authors and Affiliations

  • John A. Abraham
    • 1
  • Francis J. Hornicek
    • 1
  • Adam M. Kaufman
    • 1
  • David C. Harmon
    • 3
  • Dempsey S. Springfield
    • 1
  • Kevin A. Raskin
    • 1
  • Henry J. Mankin
    • 1
  • David G. Kirsch
    • 2
  • Andrew E. Rosenberg
    • 4
  • G. Petur Nielsen
    • 4
  • Vikram Desphpande
    • 4
  • Herman D. Suit
    • 2
  • Thomas F. DeLaney
    • 2
  • Sam S. Yoon
    • 5
  1. 1.Orthopedic Oncology, Department of OrthopedicsMassachusetts General HospitalBostonMassachusetts
  2. 2.Department of Radiation OncologyMassachusetts General HospitalBostonMassachusetts
  3. 3.Hematology/Oncology, Department of MedicineMassachusetts General HospitalBostonMassachusetts
  4. 4.Department of PathologyMassachusetts General HospitalBostonMassachusetts
  5. 5.Surgical Oncology, Department of SurgeryMassachusetts General HospitalBostonMassachusetts

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