Angiosarcoma Outcomes and Prognostic Factors

Abstract

Objective Angiosarcoma is an aggressive malignancy with endothelial differentiation and notoriously poor prognosis despite aggressive therapy. Limited data are available to guide management decisions. To address this limitation, we present a large retrospective analysis of angiosarcoma patients treated at a single institution over a 25-year period. Methods To identify factors that impact angiosarcoma outcomes, we reviewed demographic, tumor and treatment characteristics of angiosarcoma patients evaluated at the University of Wisconsin Hospital between 1987 and 2012. Results The cohort included 81 patients diagnosed at age 19–90 yo (median 67). Fifty-five (68%) patients presented with localized disease while 26 (32%) presented with metastases. The primary sites were visceral/deep soft tissue (42%), head and neck/cutaneous (37%), breast (16%) and limbs in the setting of Stewart-Treves (5%). The 5-year overall survival (OS) was 40% with a median of 16 months. By univariate analysis, significant adverse predictors of survival included metastases at presentation, visceral/deep soft tissue tumor location, tumor size > 5 cm, tumor necrosis and the absence of surgical excision. A trend toward prolonged survival was observed with radiation therapy and for chemotherapy in patients with metastases. Age, sex, and prior radiation showed no correlation with survival. Conclusions Our large single institution series confirms the poor prognosis of angiosarcoma, supports a central role for surgical excision in management and highlights the need for novel therapies particularly in patients who present with metastatic disease.

Cutaneous versus Non-Cutaneous Angiosarcoma: Clinicopathologic Features and Treatment Outcomes in 60 Patients at a Single Asian Cancer Centre

“…Strikingly in our series, C-AS affecting the scalp and face comprised 95% of C-AS, and two-thirds of the entire cohort. This contrasts with reports in other series of Western patients with AS where scalp or cutaneous head and neck AS, though forming the majority of head and neck AS, comprises only between 20 and 37% of all patients with AS [10,21]. It has been suggested that AS of the scalp is more common in Asian as compared with Western patients; our data certainly supports this observation.…”

Repurposing Drugs in Oncology (ReDO)—Propranolol as an anti-cancer agent

“…Angiosarcoma is a rare and aggressive soft tissue sarcoma arising in vascular endothelial cells, and is a disease with poor prognosis and reported five-year overall survival rates in the range 30% - 40% [181]. Although no standard treatment exists, the majority of patients are treated with surgical resection, chemotherapy (doxorubicin or paclitaxel most commonly) and radiotherapy [182].…”

Safe and Effective Sarcoma Therapy through Bispecific Targeting of EGFR and uPAR

“…Canine hemangiosarcoma and human angiosarcoma are both vasoformative sarcomas with similar microscopic appearance [13] that have often metastasized by the time they are diagnosed. Humans with angiosarcoma have an expected median survival of approximately 16 months [14]; dogs with HSA have a comparable, short median survival of 4 to 6 months when treated with the standard-of-care of surgery and adjuvant chemotherapy [15, 16]. Morbidity and mortality are usually caused by metastatic spread and/or acute internal hemorrhage secondary to tumor rupture.…”