Abstract: Objective To analyze the survival and prognostic factors in the treatment of angiosarcoma. Methods A retrospective study was performed on clinical data of 30 patients pathologically diagnosed with angiosarcoma who were admitted to our hospital from 1988 to 2015 and had complete follow-up data. In those patients, 18 patients received comprehensive treatment, containing 9 patients treated with surgery plus radiotherapy, 4 patients with surgery plus chemoradiotherapy, and 5 with surgery plus chemotherapy;12 patients received non-comprehensive treatment, containing 11 patients treated with surgery alone and 1 patient radiotherapy alone. The survival rates were calculated using the Kaplan-Meier method and analyzed using the log-rank test. The Cox regression model was used for multivariate prognostic analyses. Results The 1-, 2-, and 5-year sample sizes were 29,26, and 18, respectively. The 1-, 2-, and 5-year overall survival (OS) rates were 70.1%, 49.1%, and 40.9%, respectively;the 1-, 2-, and 5-year local relapse-free survival rates were 52.8%, 44.0%, and 35.2%, respectively;the 1-, 2-, and 5-year distant metastasis-free survival rates were 81.6%, 68.0%, and 56.7%, respectively. The multivariate analysis showed that tumor site, tumor size, staging, and visible tumor residue after initial treatment were prognostic factors for OS (P=0.027,0.027,0.011,0.000);In the patients with stage Ⅰ or Ⅱ disease, the comprehensive treatment achieved a significantly lower local-relapse rate than the individual treatment (P=0.006);gender, age, staging, and tumor site were prognostic factors for distant metastasis (P=0.028,0.011,0.015,0.022). Conclusions Early diagnosis and early treatment are recommended for angiosarcoma, which has high local recurrence and distant metastasis rates. Comprehensive treatment (surgery plus radiotherapy and/or chemotherapy) is recommended for patients with stage Ⅰ or Ⅱ disease. Tumor site, tumor size, staging, and visible tumor residue after initial treatment are prognostic factors.
Zhang Min,Gao Xianshu,Ma Mingwei et al. Treatment of angiosarcoma at a single institution[J]. Chinese Journal of Radiation Oncology, 2016, 25(10): 1092-1095.
[1] Abraham JA,Hornicek FJ,Kaufman AM,et al. Treatment and outcome of 82 patients with angiosarcoma[J].Ann Surg Oncol,2007,14(6):1953-1967.DOI:10.1245/s10434-006-9335-y. [2] Penel N,Grosjean J,Robin YM,et al. Frequency of certain established risk factors in soft tissue sarcomas in adults:a prospective descriptive study of 658 cases[J]. Sarcoma,2008,2008:459386.DOI:10.1155/2008/459386. [3] Ohguri T,Imada H,Nomoto S,et al. Angiosarcoma of the scalp treated with curative radiotherapy plus recombinant interleukin-2 immunotherapy[J].Int J Radiat Oncol Biol Phys,2005,61(5):1446-1453.DOI:10.1016/j.ijrobp.2004.08.008. [4] K hler HF,Neves RI,Brechtbühl ER,et al. Cutaneous angio-sarcoma of the head and neck:report of 23 cases from a single institution[J].Otolaryngol Head Neck Surg,2008,139(4):519-524.DOI:10.1016/j.otohns.2008.07.022. [5] Mark RJ,Poen JC,Tran LM,et al. Angiosarcoma:a report of 67 patients and a review of the literature[J].Cancer,1996, 77(11):2400-2406.DOI:10.1002/(SICI)1097-0142(19960601) 77:11<2400::AID-CNCR32>3.0.CO;2-Z. [6] 高远红,张玉晶,钱图南,等.血管肉瘤的临床分析[J].中华放射肿瘤学杂志,2000,9(4):248-251.DOI:10.3760/j.issn.1004-4221. 2000.04.009. Gao YH,Zhang YJ,Qian TN,et al. Analysis of 41 patients with angiosarcomas[J].Chin J Radiat Oncol,2000,9(4):248-251. DOI:10.3760/j.issn.1004-4221.2000.04.009. [7] Albores-Saavedra J,Schwartz AM,Henson DE,et al. Cutaneous angiosarcoma. Analysis of 434 cases from the Surveillance, Epidemiology,and En. Results Program,1973-2007[J].Ann Diagn Pathol,2011,15(2):93-97.DOI:10.1016/j.anndiagpath. 2010.07.012. [8] Depla AL,Scharloo-Karels CH,de Jong MAA,et al. Treatment and prognostic factors of radiation-associated angiosarcoma (RAAS) after primary breast cancer:a systematic review[J]. Eur J Cancer,2014,50(10):1779-1788.DOI:10.1016/j.ejca. 2014.03.002. [9] Guadagnolo BA,Zagars GK,Araujo D,et al. Outcomes after definitive treatment for cutaneous angiosarcoma of the face and scalp[J].Head Neck, 2011,33(5):661-667.DOI:10.1002/hed.21513. [10] Ogawa K,Takahashi K,Asato Y,et al. Treatment and prognosis of angiosarcoma of the scalp and face:a retrospective analysis of 48 patients[J].Br J Radiol,2012,85(1019):e1127-e1133.DOI:10.1259/bjr/31655219. [11] Miki Y,Tada T,Kamo R,et al. Single institutional experience of the treatment of angiosarcoma of the face and scalp[J].Br J Radiol,2013,86(1030):20130439.DOI:10.1259/bjr.2013043 9. [12] Patel SH,Hayden RE,Hinni ML,et al. Angiosarcoma of the scalp and face:the Mayo Clinic experience[J].JAMA Otolaryngol Head Neck Surg,2015,141(4):335-340. DOI:10.1001/jamaoto. 2014.3584. [13] Fury MG,Antonescu CR,Van Zee KJ,et al. A 14-year retrospec-tive review of angiosarcoma:clinical characteristics, prognostic factors,and treatment outcomes with surgery and chemotherapy[J].Cancer J,2005,11(3):241-247.DOI:10.1097/00130404-200505000-00011. [14] Hodgkinson DJ,Soule EH,Woods JE.Cutaneous angiosarcoma of the head and neck[J].Cancer 1979,44(3):1106-1113. DOI:10.1002/1097-0142(197909)44:3<1106::AID-CNCR2820440345>3.0.CO;2-C. [15] Fayette J,Martin E,Piperno-Neumann S,et al. Angiosarcomas,a heterogeneous group of sarcomas with specific behavior depending on primary site:a retrospective study of 161 cases[J].Ann Oncol,2007,18(12):2030-2036.DOI:10.1093/an nonc/mdm381. [16] LeBoit PE,Burg G,Weedon D,et al. Pathology and Genetics of Skin Tumors[M].Lyon:IARC Press,2006:20-25,245-246. [17] Lahat G,Dhuka AR,Lahat S,et al. Outcome of locally recurrent and metastatic angiosarcoma[J].Ann Surg Oncol,2009,16(9):2502-2509.DOI:10.1245/s10434-009-0569-3. [18] Hwang K,Kim MY,Lee SH.Recommendations for therapeutic decisions of angiosarcoma of the scalp and face[J].J Craniofac Surg,2015,26(3):e253-e256.DOI:10.1097/SCS.0000 000000001495.