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 Rosenberg, G. Petur Nielsen, Vikram Desphpande, Herman D. Suit, Thomas F. DeLaney, Sam S. Yoon

Research output: Contribution to journalArticle

170 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1953-1967
Number of pages15
JournalAnnals of Surgical Oncology
Volume14
Issue number6
DOIs
StatePublished - Jun 1 2007
Externally publishedYes

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Hemangiosarcoma
Neoplasms
Lymphedema
Radiation
Drug Therapy
Survival
Skin
Adjuvant Chemotherapy
Breast
Radiotherapy
Demography
Bone and Bones

Keywords

  • Angiosarcoma
  • Outcome
  • Radiotherapy
  • Sarcoma

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Abraham, J. A., Hornicek, F. J., Kaufman, A. M., Harmon, D. C., Springfield, D. S., Raskin, K. A., ... Yoon, S. S. (2007). Treatment and outcome of 82 patients with angiosarcoma. Annals of Surgical Oncology, 14(6), 1953-1967. https://doi.org/10.1245/s10434-006-9335-y

Treatment and outcome of 82 patients with angiosarcoma. / Abraham, John A.; Hornicek, Francis J.; Kaufman, Adam M.; Harmon, David C.; Springfield, Dempsey S.; Raskin, Kevin A.; Mankin, Henry J.; Kirsch, David G.; Rosenberg, Andrew; Nielsen, G. Petur; Desphpande, Vikram; Suit, Herman D.; DeLaney, Thomas F.; Yoon, Sam S.

In: Annals of Surgical Oncology, Vol. 14, No. 6, 01.06.2007, p. 1953-1967.

Research output: Contribution to journalArticle

Abraham, JA, Hornicek, FJ, Kaufman, AM, Harmon, DC, Springfield, DS, Raskin, KA, Mankin, HJ, Kirsch, DG, Rosenberg, A, Nielsen, GP, Desphpande, V, Suit, HD, DeLaney, TF & Yoon, SS 2007, 'Treatment and outcome of 82 patients with angiosarcoma', Annals of Surgical Oncology, vol. 14, no. 6, pp. 1953-1967. https://doi.org/10.1245/s10434-006-9335-y
Abraham JA, Hornicek FJ, Kaufman AM, Harmon DC, Springfield DS, Raskin KA et al. Treatment and outcome of 82 patients with angiosarcoma. Annals of Surgical Oncology. 2007 Jun 1;14(6):1953-1967. https://doi.org/10.1245/s10434-006-9335-y
Abraham, John A. ; Hornicek, Francis J. ; Kaufman, Adam M. ; Harmon, David C. ; Springfield, Dempsey S. ; Raskin, Kevin A. ; Mankin, Henry J. ; Kirsch, David G. ; Rosenberg, Andrew ; Nielsen, G. Petur ; Desphpande, Vikram ; Suit, Herman D. ; DeLaney, Thomas F. ; Yoon, Sam S. / Treatment and outcome of 82 patients with angiosarcoma. In: Annals of Surgical Oncology. 2007 ; Vol. 14, No. 6. pp. 1953-1967.
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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.",
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AU - Abraham, John A.

AU - Hornicek, Francis J.

AU - Kaufman, Adam M.

AU - Harmon, David C.

AU - Springfield, Dempsey S.

AU - Raskin, Kevin A.

AU - Mankin, Henry J.

AU - Kirsch, David G.

AU - Rosenberg, Andrew

AU - Nielsen, G. Petur

AU - Desphpande, Vikram

AU - Suit, Herman D.

AU - DeLaney, Thomas F.

AU - Yoon, Sam S.

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N2 - 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.

AB - 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.

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KW - Outcome

KW - Radiotherapy

KW - Sarcoma

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