Challenges in the treatment of angiosarcoma: a single institution experience

Am J Surg. 2014 Aug;208(2):254-9. doi: 10.1016/j.amjsurg.2014.01.007. Epub 2014 Apr 15.

Abstract

Background: Angiosarcomas are rare tumors that carry poor prognosis. Because of insidious growth rate, the diagnosis is often difficult and delayed.

Methods: Between 1990 and 2011, 72 (41 female, 31 male) patients were treated at our institution. Pathologic confirmation was obtained and multiple prognostic factors were evaluated for survival.

Results: Forty-four cases were sporadic and 28 cases were secondary. In the sporadic group, 16 (36%) patients had increased sun exposure, while in the secondary group, the majority (n = 23, 82%) of patients had prior exposure to radiation. The latent period between radiation exposure and diagnosis was predictive of survival (P = .037). Presentation was delayed by more than 3 months in 41% of patients. The majority of men developed head and neck angiosarcomas (n = 15, 48.5%), while women developed breast angiosarcomas (n = 21, 51%). Median survival was prolonged in patients treated initially with surgery.

Conclusions: A delay in the diagnosis of angiosarcoma can affect survival. Clinical suspicion and prompt diagnosis are essential for successful multimodal therapy. Initial surgical resection with adjuvant chemotherapy provides survival advantage.

Keywords: Angiosarcoma; Chemotherapy; Radiation; Surgery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / mortality*
  • Combined Modality Therapy
  • Female
  • Head and Neck Neoplasms / diagnosis
  • Head and Neck Neoplasms / drug therapy
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / radiotherapy
  • Hemangiosarcoma / diagnosis
  • Hemangiosarcoma / drug therapy
  • Hemangiosarcoma / mortality*
  • Hemangiosarcoma / radiotherapy
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Prognosis
  • Young Adult