Treatment of angiosarcoma at a single institution

Abstract

Objective To analyze the survival and prognostic factors in the treatment of angiosarcoma. Methods A retrospective study was performed on clinical data of 30 patients pathologically diagnosed with angiosarcoma who were admitted to our hospital from 1988 to 2015 and had complete follow-up data. In those patients, 18 patients received comprehensive treatment, containing 9 patients treated with surgery plus radiotherapy, 4 patients with surgery plus chemoradiotherapy, and 5 with surgery plus chemotherapy; 12 patients received non-comprehensive treatment, containing 11 patients treated with surgery alone and 1 patient radiotherapy alone. The survival rates were calculated using the Kaplan-Meier method and analyzed using the log-rank test. The Cox regression model was used for multivariate prognostic analyses. Results The 1-, 2-, and 5-year sample sizes were 29, 26, and 18, respectively. The 1-, 2-, and 5-year overall survival (OS) rates were 70.1%, 49.1%, and 40.9%, respectively; the 1-, 2-, and 5-year local relapse-free survival rates were 52.8%, 44.0%, and 35.2%, respectively; the 1-, 2-, and 5-year distant metastasis-free survival rates were 81.6%, 68.0%, and 56.7%, respectively. The multivariate analysis showed that tumor site, tumor size, staging, and visible tumor residue after initial treatment were prognostic factors for OS (P=0.027, 0.027, 0.011, 0.000); In the patients with stage Ⅰ or Ⅱ disease, the comprehensive treatment achieved a significantly lower local-relapse rate than the individual treatment (P=0.006); gender, age, staging, and tumor site were prognostic factors for distant metastasis (P=0.028, 0.011, 0.015, 0.022). Conclusions Early diagnosis and early treatment are recommended for angiosarcoma, which has high local recurrence and distant metastasis rates. Comprehensive treatment (surgery plus radiotherapy and/or chemotherapy) is recommended for patients with stage Ⅰ or Ⅱ disease. Tumor site, tumor size, staging, and visible tumor residue after initial treatment are prognostic factors. Key words: Angiosarcomas/surgery; Angiosarcomas/radiotherapy; Angiosarcomas/chemotherapy; Prognosis