Skip to main content

Advertisement

SpringerLink
Log in

Management of angiosarcoma

  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Angiosarcoma is an uncommon tumor that presents in several scenarios. Although angiosarcoma can occur in any organ, it typically presents in the following settings: 1) in the face or scalp among elderly patients, 2) with chronic lymphedema, 3) after radiotherapy, or 4) as a hepatic primary. In all of these situations, angiosarcoma is associated with multifocality and an insidious growth pattern, making local control difficult. Doxorubicin-ifosfamide chemotherapy produces a modest response rate, and paclitaxel appears to be useful for scalp and facial angiosarcomas. However, improvement in systemic therapy is clearly needed. One logical strategy is to investigate antiangiogenic therapies in this endothelial tumor. Improved therapy for this tumor will come only with greater understanding of its biology.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Holden CA, Spittle MF, Jones EW: Angiosarcoma of the face and scalp, prognosis and treatment. Cancer 1987, 59:1046–1057.

    Article  PubMed  CAS  Google Scholar 

  2. Morrison WH, Byers RM, Garden AS, et al.: Cutaneous angiosarcoma of the head and neck: a therapeutic dilemma. Cancer 1995, 76:319–327.

    Article  PubMed  CAS  Google Scholar 

  3. Sasaki R, Soejima T, Kishi K, et al.: Angiosarcoma treated with radiotherapy: impact of tumor type and size on outcome. Int J Radiat Oncol Biol Phys 2002, 52:1032–1040.

    Article  PubMed  Google Scholar 

  4. Stewart FW, Treves N: Lymphangiosarcoma in postmastectomy lymphedema. Cancer 1948, 1:64–81. This is the classic report of lymphangiosarcoma in postmastectomy lymphedema, a clinical scenario now termed the Stewart-Treves syndrome.

    Article  PubMed  CAS  Google Scholar 

  5. Stewart FW, Treves N: Classics in oncology: lymphangiosarcoma in postmastectomy lymphedema: a report of six cases in elephantiasis chirurgica. CA Cancer J Clin 1981, 31:284–299.

    PubMed  CAS  Google Scholar 

  6. Grobmyer SR, Daly JM, Glotzbach RE, Grobmyer AJ III: Role of surgery in the management of postmastectomy extremity angiosarcoma (Stewart-Treves syndrome). J Surg Oncol 2000, 73:182–188.

    Article  PubMed  CAS  Google Scholar 

  7. Alessi E, Sala F, Berti E: Angiosarcomas in lymphedematous limbs. Am J Dermatopathol 1986, 8:371–378.

    Article  PubMed  CAS  Google Scholar 

  8. Marchal C, Weber B, de Lafontan B, et al.: Nine breast angiosarcomas after conservative treatment for breast carcinoma: a survey from French comprehensive cancer centers. Int J Radiat Oncol Biol Phys 1999, 44:113–119. This report describes the French experience with angiosarcoma occurring after breast-conserving therapy.

    Article  PubMed  CAS  Google Scholar 

  9. Cahan WG, Woodard HQ, Higinbotham NL, et al.: Sarcoma arising in irradiated bone: report of eleven cases. Cancer 1998, 82:8–34.

    Article  PubMed  CAS  Google Scholar 

  10. Yap J, Chuba PJ, Thomas R, et al.: Sarcoma as a second malignancy after treatment for breast cancer. Int J Radiat Oncol Biol Phys 2002, 52:1231–1237. This study reports the US experience with angiosarcoma arising after breast-conserving therapy.

    Article  PubMed  Google Scholar 

  11. Poggio JL, Nagorney DM, Nascimento AG, et al.: Surgical treatment of adult primary hepatic sarcoma. Br J Surg 2000, 87:1500–1505.

    Article  PubMed  CAS  Google Scholar 

  12. Shiraki M, Enterline HT, Brooks JJ, et al.: Pathologic analysis of advanced adult soft tissue sarcomas, bone sarcomas, and mesotheliomas. The Eastern Cooperative Oncology Group (ECOG) experience. Cancer 1989, 64:484–490.

    Article  PubMed  CAS  Google Scholar 

  13. Borden EC, Amato DA, Rosenbaum C, et al.: Randomized comparison of three adriamycin regimens for metastatic soft tissue sarcomas. J Clin Oncol 1987, 5:840–850.

    PubMed  CAS  Google Scholar 

  14. Edmonson JH, Ryan LM, Blum RH, et al.: Randomized comparison of doxorubicin alone versus ifosfamide plus doxorubicin or mitomycin, doxorubicin, and cisplatin against advanced soft tissue sarcomas. J Clin Oncol 1993, 11:1269–1275.

    PubMed  CAS  Google Scholar 

  15. Baker LH, Frank J, Fine G, et al.: Combination chemotherapy using adriamycin, DTIC, cyclophosphamide, and actinomycin D for advanced soft tissue sarcomas: a randomized comparative trial: a phase III Southwest Oncology Group Study (7613). J Clin Oncol 1987, 5:851–861.

    PubMed  CAS  Google Scholar 

  16. Antman K, Crowley J, Balcerzak SP, et al.: An intergroup phase III randomized study of doxorubicin and dacarbazine with or without ifosfamide and mesna in advanced soft tissue and bone sarcomas. J Clin Oncol 1993, 11:1276–1285.

    PubMed  CAS  Google Scholar 

  17. Verweij J, Lee SM, Ruka W, et al.: Randomized phase II study of docetaxel versus doxorubicin in first-and second-line chemotherapy for locally advanced or metastatic soft tissue sarcomas in adults: a study of the European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group. J Clin Oncol 2000, 18:2081–2086.

    PubMed  CAS  Google Scholar 

  18. Santoro A, Tursz T, Mouridsen H, et al.: Doxorubicin versus CYVADIC versus doxorubicin plus ifosfamide in first-line treatment of advanced soft tissue sarcomas: a randomized study of the European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group. J Clin Oncol 1995, 13:1537–1545.

    PubMed  CAS  Google Scholar 

  19. Balcerzak SP, Benedetti J, Weiss GR, Natale RB: A phase II trial of paclitaxel in patients with advanced soft tissue sarcomas: a Southwest Oncology Group study. Cancer 1995, 76:2248–2252.

    Article  PubMed  CAS  Google Scholar 

  20. Casper ES, Waltzman RJ, Schwartz GK, et al.: Phase II trial of paclitaxel in patients with soft-tissue sarcoma. Cancer Invest 1998, 16:442–446.

    PubMed  CAS  Google Scholar 

  21. Gian VG, Johnson TJ, Marsh RW, et al.: A phase II trial of paclitaxel in the treatment of recurrent or metastatic soft tissue sarcomas or bone sarcomas. J Exp Ther Oncol 1996, 1:186–190.

    PubMed  CAS  Google Scholar 

  22. Fata F, O’Reilly E, Ilson D, et al.: Paclitaxel in the treatment of patients with angiosarcoma of the scalp or face. Cancer 1999, 86:2034–2037. This report is the initial observation from investigators at Memorial Sloan-Kettering Cancer Center of responses of angiosarcoma of the scalp or face to treatment with paclitaxel.

    Article  PubMed  CAS  Google Scholar 

  23. Borden EC, Kim K, Ryan L, et al.: Phase II trials of interferonsalpha and -beta in advanced sarcomas. J Interferon Res 1992, 12:455–458.

    PubMed  CAS  Google Scholar 

  24. Guillot B, Raison-Peyron N, Acevedo M, et al.: Angiosarcoma of the scalp and face: failure of an interferon alpha treatment. Eur J Dermatol 2000, 10:300–302.

    PubMed  CAS  Google Scholar 

  25. Spieth K, Gille J, Kaufmann R: Therapeutic efficacy of interferon alfa-2a and 13-cis-retinoic acid in recurrent angiosarcoma of the head. Arch Dermatol 1999, 135:1035–1037.

    Article  PubMed  CAS  Google Scholar 

  26. Jackel A, Deichmann M, Waldmann V, et al.: Regression of metastatic angiosarcoma of the skin after systemic treatment with liposome-encapsulated doxorubicin and interferonalpha. Br J Dermatol 1999, 140:1187–1188.

    PubMed  CAS  Google Scholar 

  27. Tomlinson J, Barsky SH, Nelson S, et al.: Different patterns of angiogenesis in sarcomas and carcinomas. Clin Cancer Res 1999, 5:3516–3522.

    PubMed  CAS  Google Scholar 

  28. Ohsawa M, Tomita Y, Kuratsu S, et al.: Angiogenesis in malignant fibrous histiocytoma. Oncology 1995, 52:51–54.

    Article  PubMed  CAS  Google Scholar 

  29. Saenz NC, Heslin MJ, Adsay V, et al.: Neovascularity and clinical outcome in high-grade extremity soft tissue sarcomas. Ann Surg Oncol 1998, 5:48–53.

    Article  PubMed  CAS  Google Scholar 

  30. Kawauchi S, Fukuda T, Tsuneyoshi M: Angiogenesis does not correlate with prognosis or expression of vascular endothelial growth factor in synovial sarcomas. Oncol Rep 1999, 6:959–964.

    PubMed  CAS  Google Scholar 

  31. Verheul HM, Hoekman K, Lupu F, et al.: Platelet and coagulation activation with vascular endothelial growth factor generation in soft tissue sarcomas. Clin Cancer Res 2000, 6:166–171.

    PubMed  CAS  Google Scholar 

  32. Graeven U, Andre N, Achilles E, et al.: Serum levels of vascular endothelial growth factor and basic fibroblast growth factor in patients with soft-tissue sarcoma. J Cancer Res Clin Oncol 1999, 125:577–581.

    Article  PubMed  CAS  Google Scholar 

  33. Kuhnen C, Lehnhardt M, Tolnay E, et al.: Patterns of expression and secretion of vascular endothelial growth factor in malignant soft-tissue tumours. J Cancer Res Clin Oncol 2000, 126:219–225.

    Article  PubMed  CAS  Google Scholar 

  34. Meyers M, Clasen C, Gebhardt B, et al.: Gene expression of VEGF in human sarcoma [abstract]. Proc ASCO 2000, 19:554a.

    Google Scholar 

  35. Hashimoto M, Ohsawa M, Ohnishi A, et al.: Expression of vascular endothelial growth factor and its receptor mRNA in angiosarcoma. Lab Invest 1995, 73:859–863.

    PubMed  CAS  Google Scholar 

  36. Zietz C, Rossle M, Haas C, et al.: MDM-2 oncoprotein overexpression, p53 gene mutation, and VEGF up-regulation in angiosarcomas. Am J Pathol 1998, 153:1425–1433.

    PubMed  CAS  Google Scholar 

  37. Yamamoto T, Umeda T, Yokozeki H, Nishioka K: Expression of basic fibroblast growth factor and its receptor in angiosarcoma. J Am Acad Dermatol 1999, 41:127–129.

    Article  PubMed  CAS  Google Scholar 

  38. Kalebic T, Tsokos M, Helman LJ: Suppression of rhabdomyosarcoma growth by fumagillin analog TNP-470. Int J Cancer 1996, 68:596–599.

    Article  PubMed  CAS  Google Scholar 

  39. Brekken RA, Overholser JP, Stastny VA, et al.: Selective inhibition of vascular endothelial growth factor (VEGF) receptor 2 (KDR/Flk-1) activity by a monoclonal anti-VEGF antibody blocks tumor growth in mice. Cancer Res 2000, 60:5117–5124.

    PubMed  CAS  Google Scholar 

  40. Liekens S, De Clercq E, Neyts J: Angiogenesis: regulators and clinical applications. Biochem Pharmacol 2001, 61:253–270.

    Article  PubMed  CAS  Google Scholar 

  41. Ezekowitz RA, Mulliken JB, Folkman J: Interferon alfa-2a therapy for life-threatening hemangiomas of infancy. N Engl J Med 1992, 326:1456–1463.

    Article  PubMed  CAS  Google Scholar 

  42. Riedel F, Gotte K, Bergler W, et al.: Expression of basic fibroblast growth factor protein and its down-regulation by interferons in head and neck cancer. Head Neck 2000, 22:183–189.

    Article  PubMed  CAS  Google Scholar 

  43. Salven P, Anttonen K, Repo H, et al.: Endotoxins induce and interferon alpha suppresses vascular endothelial growth factor (VEGF) production in human peripheral blood mononuclear cells. FASEB J 2001, 15:1318–1320.

    PubMed  CAS  Google Scholar 

  44. Zeuzem S, Feinman SV, Rasenack J, et al.: Peginterferon alfa-2a in patients with chronic hepatitis C. N Engl J Med 2000, 343:1666–1672.

    Article  PubMed  CAS  Google Scholar 

  45. Heathcote EJ, Shiffman ML, Cooksley WG, et al.: Peginterferon alfa-2a in patients with chronic hepatitis C and cirrhosis. N Engl J Med 2000, 343:1673–1680.

    Article  PubMed  CAS  Google Scholar 

  46. Arbiser JL, Panigrathy D, Klauber N, et al.: The antiangiogenic agents TNP-470 and 2-methoxyestradiol inhibit the growth of angiosarcoma in mice. J Am Acad Dermatol 1999, 40:925–929. This laboratory study describes a model tumor system and the activity of several antiangiogenic agents in the treatment of this model tumor.

    Article  PubMed  CAS  Google Scholar 

  47. Ruggeri BA, Robinson C, Angeles T, et al.: The chemopreventive agent oltipraz possesses potent antiangiogenic activity in vitro, ex vivo, and in vivo and inhibits tumor xenograft growth. Clin Cancer Res 2002, 8:267–274.

    PubMed  CAS  Google Scholar 

  48. Liekens S, Verbeken E, Vandeputte M, et al.: A novel animal model for hemangiomas: inhibition of hemangioma development by the angiogenesis inhibitor TNP-470. Cancer Res 1999, 59:2376–2683.

    PubMed  CAS  Google Scholar 

  49. Fong TA, Shawver LK, Sun L, et al.: SU5416 is a potent and selective inhibitor of the vascular endothelial growth factor receptor (Flk-1/KDR) that inhibits tyrosine kinase catalysis, tumor vascularization, and growth of multiple tumor types. Cancer Res 1999, 59:99–106.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Hematology and Medical Oncology, The Cleveland Clinic Foundation, R35, 9500 Euclid Avenue, 44195, Cleveland, OH, USA

    G. Thomas Budd MD

Authors
  1. G. Thomas Budd MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Budd, G.T. Management of angiosarcoma. Curr Oncol Rep 4, 515–519 (2002). https://doi.org/10.1007/s11912-002-0066-3

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11912-002-0066-3

Keywords

Search

Navigation