Treatment and Outcome of 82 Patients with Angiosarcoma

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Treatment and Outcome of 82 Patients with Angiosarcoma

Postby patoco » Sat Mar 17, 2007 8:17 am

Treatment and Outcome of 82 Patients with Angiosarcoma

Because angiosarcomas, especially lymphangiosarcoma is a recognized possible complication of long standing or late stage lymphedema, I wanted to pass on this abstract just released on the treatment and outcome of angiosarcoma,

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Abstract:

Treatment and Outcome of 82 Patients with Angiosarcoma

Ann Surg Oncol. 2007 Mar 14

Abraham JA, Hornicek FJ, Kaufman AM, Harmon DC, Springfield DS, Raskin KA, Mankin HJ, Kirsch DG, Rosenberg AE, Nielsen GP, Desphpande V, Suit HD, Delaney TF, Yoon SS.
Orthopedic Oncology, Department of Orthopedics, Massachusetts General Hospital, Yawkey 7B-7926, 55 Fruit Street, Boston, Massachusetts, 02114.

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.

PMID: 17356953 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum

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Related Abstract

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Angiosarcoma in chronic lymphedema


Actas Dermosifiliogr. 2006 Oct

Rodriguez-Bujaldon A, Vazquez-Bayo MC, Galan-Gutierrez M, Jimenez-Puya R, Velez Garcia-Nieto A, Moreno-Gimenez JC, Vidal-Jimenez A, Barroso-Casamitjana E.
Servicio de Dermatologia, Hospital Universitario Reina Sofia, Cordoba, Espana. alfonsobujaldon@yahoo.es

Angiosarcoma that develops on a limb with chronic lymphedema is called Stewart-Treves syndrome. This typically appears as a complication of a long course lymphedema located on the arm, after mastectomy and/or radiotherapy due to breast cancer.

There are cases of Stewart-Treves syndrome in chronic lymphedema in the upper limb contralateral to the breast treated for cancer and in chronic lymphedema of the leg. We present two cases of this syndrome.

The first corresponds to a typical syndrome of Stewart-Treves in an 83-year-old woman who was diagnosed of angiosarcoma in a chronic lymphedema territory secondary to mastectomy and radiotherapy due to breast cancer. The second case is much rarer, since it is a case of diffuse angiosarcoma of the leg in a 42-year-old man with a history of lymphedema. Due to the aggressive nature of this syndrome, knowledge and research on its treatment are necessary.

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum

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Pat O'Connor
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