Angiosarcoma after radiotherapy: a cohort study of 332 163 Finnish cancer patients

Abstract

We evaluated the risk of angiosarcoma after radiotherapy among all patients with cancers of breast, cervix uteri, corpus uteri, lung, ovary, prostate, or rectum, and lymphoma diagnosed in Finland during 1953Finland during -2003, identified from the Finnish Cancer Registry. Only angiosarcomas of the trunk were considered, this being the target of radiotherapy for the first cancer. In the follow-up of 1.8 million person-years at risk, 19 angiosarcomas developed, all after breast and gynaecological cancer. Excess of angiosarcomas over national incidence rates were observed after radiotherapy without chemotherapy (standardised incidence ratio (SIR) 6.0, 95% confidence interval (CI) 2.7 -11), after both radiotherapy and chemotherapy (SIR 100, 95% CI 12 -360), and after other treatments (SIR 3.6, 95% CI 1.6 -7.1). In the regression analysis however, the adjusted rate ratio for radiotherapy was 1.0 (95% CI 0.23 -4.4). Although an increased risk of angiosarcoma among cancer patients is evident, especially with breast and gynaecological cancer, the excess does not appear to be strongly related to radiotherapy.

Masson's Vegetant Hemangioendothelioma Arising in the Uterine Cervix During Pregnancy: A Case Report

“…2 Pelvic angiosarcoma is very rare; a few cases of uterine, cervical, and vaginal angiosarcoma have been reported in the literature, always in patients who underwent pelvic radiation for gynecological cancers. 11 Histologically, angiosarcoma is composed of irregular anastomosing vascular channels and exhibits an invasive growth pattern, with frequent mitotic figures, cellular pleomorphism, and areas of necrosis. Masson's tumor, instead, presents a single layer of endothelial cells without nuclear anaplasia.…”

The Association Between Biological Subtype and Isolated Regional Nodal Failure After Breast-Conserving Therapy

“…Retrospective series, however, report low rates of isolated regional nodal failure (RNF), suggesting that perhaps routine RNI may not be necessary (6)(7)(8)(9). Moreover, RNI is not without potential complications, including radiation pneumonitis (10), arm lymphedema (11), long-term cardiotoxicity (12), brachial plexopathy (13), and secondary cancers (14,15). Therefore the risk of RNI should be weighed against an individual's predicted risk of RNF based on available clinical, pathologic, and molecular factors.…”

Clinical and Molecular Biology of Angiosarcoma

“…However, a recent retrospective study of Finnish cancer patients showed different results (Virtanen et al 2007). Surveying more than 300,000 cancer patient records accrued over a 50-year period, Virtanen et al (2007) failed to identify a statistically significant association of AS with prior radiation treatment.…”

“…Surveying more than 300,000 cancer patient records accrued over a 50-year period, Virtanen et al (2007) failed to identify a statistically significant association of AS with prior radiation treatment. These results agree with an earlier Swedish study of 122,991 women with breast cancer that showed no statistically significant correlation between radiation therapy and angiosarcoma, although they did observe a correlation with lymphedema (Karlsson et al 1998).…”