Outcome of locally recurrent and metastatic angiosarcoma

G. Lahat, A. R. Dhuka, S. Lahat, K. D. Smith, R. E. Pollock, K. K. Hunt, V. Ravi, A. J. Lazar, D. Lev

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Angiosarcoma (AS) is a rare soft tissue sarcoma with an enhanced propensity for local and systemic failure. The outcome of locally recurrent and metastatic AS treated at a single institution was evaluated. Methods: Medical records of AS patients treated for local recurrence and distant metastasis (1993-2008) were retrospectively reviewed. Univariable and multivariable analyses were performed to identify prognosticators. Results: Forty-four patients were treated for locally recurrent AS; the majority (59%) were ≤5 cm; the most common sites were skin (48%) and breast (32%). Thirty-two patients (73%) had surgery; 73% received chemotherapy; radiation was delivered to 41%. Median disease-specific survival (DSS) was 50 months [95% confidence interval (CI): 25.7-73.5 months]. Multivariable analysis identified size >5 cm as the only independent adverse prognosticator of recurrent AS-specific survival [hazard ratio (HR): 3.26, P = 0.04]. Ninety-nine patients were treated for metastatic AS; 73% had multiple metastatic sites; the lung was the most common site (36%). Chemotherapy, mainly doxorubicin- and/or paclitaxel-based regimens, were administered to 95 patients (96%). Radiotherapy was utilized in 25% cases; 16% of patients underwent curative-intent surgery. Median DSS was 10 months (95% CI: 7.9-12 months). Isolated lymph node metastasis versus hematogenic spread was the only statistically significant favorable prognostic factor identified (HR: 0.29, P = 0.01). Conclusion: Locally recurrent AS is often treatable; complete resection can potentially prolong survival. In contrast, metastatic patients have a grave prognosis; however, patients with isolated lymphatic spread and possibly those treated with taxol-based chemotherapeutic regimens have a favorable outcome.

Original languageEnglish
Pages (from-to)2502-2509
Number of pages8
JournalAnnals of Surgical Oncology
Volume16
Issue number9
DOIs
StatePublished - Sep 2009
Externally publishedYes

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