Annals of Surgical Oncology

, Volume 14, Issue 6, pp 1953–1967

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 

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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