Clinicopathological characteristics and prognosis analysis of Aggressive angiomyxoma: A Retrospective Study

Abstract

Background: Aggressive angiomyxoma is a rare, locally invasive mesenchymal neoplasm with a high recurrence rate. However, our current research on the clinical characteristics, therapeutic strategies and prognosis of aggressive angiomyxoma is limited. This study aimed to improve the management of aggressive angiomyxoma by evaluating the clinicopathological characteristics, therapeutic strategies, and prognostic factors associated with aggressive angiomyxomas. Methods: Retrospectively analyzed the medical records of patients histopathologically diagnosed with aggressive angiomyxomas from May 2005 to January 2022. Data related to clinicopathological characteristics, therapeutic strategies, and survival time were recorded and analyzed. Survival and prognosis analyses were carried out to identify variables significantly associated with the outcomes. Results: fourteen patients were included in the study with a median follow-up of 78.8 months. Univariate Cox regression analysis identified tumor margin (P=0.012) and initial treatment site (P=0.039) as associated with disease-free survival (DFS). The Kaplan-Meier survival curve showed that tumor margin had a greater effect on the prognosis of patients. Patients with positive tumor margins had a significantly lower probability of survival with DFS than those with negative margins (HR= 3.41, CI:2.73-15.74, P=0.012). Meanwhile, we found that patients who underwent surgery in other hospitals had a lower probability of survival with DFS. This difference in survival was statistically significant (HR=1.48, CI:1.09-2.50, P=0.039). To further demonstrate the results of this study, we constructed a Nomogram model. The results showed that the tumor margin and initial treatment site had the greatest effect on patient prognosis and the greatest contribution to risk score, which confirmed the results of Kaplan-Meier survival curve analysis. Conclusion: Tumor margin and initial treatment site are closely associated with prognosis in aggressive angiomyxomas. Radical resection with negative tumor margins is the first choice of treatment for aggressive angiomyxomas. Patients with aggressive angiomyxomas should go to the comprehensive authoritative hospitals to obtain definitive diagnosis and effective treatment in in earlier stage. Furthermore, Patients with aggressive angiomyxomasrequire long-term follow-up, especially within three years after surgery.