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. 2020 Aug;13(2):179-185.
doi: 10.3892/mco.2020.2055. Epub 2020 Jun 2.

A retrospective review of 145 patients with angiosarcoma: Radiation therapy, extent of resection and chemotherapy are important predictors of survival

Alannah Smrke  1 , Jeremy Hamm  2 , Anand Karvat  3 , Christine Simmons  1 , Amirrtha Srikanthan  4
Affiliations

A retrospective review of 145 patients with angiosarcoma: Radiation therapy, extent of resection and chemotherapy are important predictors of survival

Alannah Smrke et al. Mol Clin Oncol. 2020 Aug.

Abstract

Angiosarcoma is a subset of soft-tissue sarcomas with poor 5-year survival rate. Given its rarity, limited large cohort data is available for this disease. Therefore, the present study evaluated data from patients with angiosarcoma treated at a provincial Institution (BC Cancer) to determine potential modifiable predictors of survival. A retrospective review of patients across British Columbia (Canada) was conducted at the Sarcoma Outcome Unit of BC Cancer from January 1, 1969 to September 19, 2017. Cox proportional hazard models were used to calculate hazard ratios (HR) for the overall survival (OS) and progression free survival (PFS) of patients. A total of 145 patients with angiosarcoma were identified, of which 68 were metastatic/unresectable at presentation. Of the 145 patients included, 38 received chemotherapy, with 15 receiving taxane. A single patient received chemotherapy in a neoadjuvant setting. Of the resectable patients, 71 had first line surgery and 38 had curative-intent radiation during their treatment. Of the study cohort, 38 patients received prior radiation for an unrelated cancer and 4 patients had pre-existing chronic lymphedema. Resectable disease (HR, 0.22; P<0.01), first treatment with either surgery (HR, 0.08; P<0.01), radiation (HR, 0.19; P<0.01) or chemotherapy (HR, 0.22; P<0.01) were predictors of improved OS. First line surgery resulted in improved OS (HR, 0.36; P<0.01) and PFS (HR, 0.48; P<0.01). In addition, OS was positively impacted by the extent of surgery [complete (R0) vs. microscopic residual tumor (R1); HR, 0.26; P<0.01; R0 vs. macroscopic residual tumor (R2); HR, 0.08; P<0.01) resection. Extent of surgery and any radiation treatment were determined to be important predictors of OS. The results also revealed that patient outcome was improved following any treatment compared with supportive care alone. In conclusion, multidisciplinary care is critical for the treatment of patients diagnosed with angiosarcoma.

Keywords: angiosarcoma; anthracyclines; radiation associated sarcoma; soft tissue sarcoma; taxanes.

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Figures

Figure 1
Figure 1
Kaplan-Meier curves for the entire cohort of patients diagnosed with angiosarcoma. (A) Progression free survival and (B) OS were determined.
Figure 1
Figure 1
Kaplan-Meier curves for the entire cohort of patients diagnosed with angiosarcoma. (A) Progression free survival and (B) OS were determined.
Figure 2
Figure 2
Kaplan-Meier curves for patients with angiosarcoma treated with taxane versus other systemic therapies (Taxane; n=15/38). (A) Progression free survival and (B) OS were determined. Dashed line, taxane treated patients; solid line, non-taxane treated patients.
Figure 2
Figure 2
Kaplan-Meier curves for patients with angiosarcoma treated with taxane versus other systemic therapies (Taxane; n=15/38). (A) Progression free survival and (B) OS were determined. Dashed line, taxane treated patients; solid line, non-taxane treated patients.
See this image and copyright information in PMC

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