A retrospective review of 145 patients with angiosarcoma: Radiation therapy, extent of resection and chemotherapy are important predictors of survival

Smrke,Alannah; Hamm,Jeremy; Karvat,Anand; Simmons,Christine; Srikanthan,Amirrtha

doi:10.3892/mco.2020.2055

A retrospective review of 145 patients with angiosarcoma: Radiation therapy, extent of resection and chemotherapy are important predictors of survival

Authors:
- Alannah Smrke
- Jeremy Hamm
- Anand Karvat
- Christine Simmons
- Amirrtha Srikanthan
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Affiliations: Department of Medical Oncology, BC Cancer, Vancouver Centre, Vancouver, BC V5Z4E6, Canada, Department of Cancer Surveillance Outcomes, BC Cancer, Vancouver Centre, Vancouver, BC V5Z4E6, Canada, Department of Radiation Oncology, BC Cancer‑Surrey, Surrey, BC V3V1Z2, Canada, Division of Medical Oncology, Ottawa Hospital Cancer Centre, Ottawa, ON K1H8L6, Canada
Published online on: June 2, 2020 https://doi.org/10.3892/mco.2020.2055
Pages: 179-185

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Abstract

Angiosarcoma is a subset of soft-tissue sarcomas with poor 5‑year survival rate. Given its rarity, limited large cohort data is available for this disease. Therefore, the present study evaluated data from patients with angiosarcoma treated at a provincial Institution (BC Cancer) to determine potential modifiable predictors of survival. A retrospective review of patients across British Columbia (Canada) was conducted at the Sarcoma Outcome Unit of BC Cancer from January 1, 1969 to September 19, 2017. Cox proportional hazard models were used to calculate hazard ratios (HR) for the overall survival (OS) and progression free survival (PFS) of patients. A total of 145 patients with angiosarcoma were identified, of which 68 were metastatic/unresectable at presentation. Of the 145 patients included, 38 received chemotherapy, with 15 receiving taxane. A single patient received chemotherapy in a neoadjuvant setting. Of the resectable patients, 71 had first line surgery and 38 had curative‑intent radiation during their treatment. Of the study cohort, 38 patients received prior radiation for an unrelated cancer and 4 patients had pre‑existing chronic lymphedema. Resectable disease (HR, 0.22; P<0.01), first treatment with either surgery (HR, 0.08; P<0.01), radiation (HR, 0.19; P<0.01) or chemotherapy (HR, 0.22; P<0.01) were predictors of improved OS. First line surgery resulted in improved OS (HR, 0.36; P<0.01) and PFS (HR, 0.48; P<0.01). In addition, OS was positively impacted by the extent of surgery [complete (R0) vs. microscopic residual tumor (R1); HR, 0.26; P<0.01; R0 vs. macroscopic residual tumor (R2); HR, 0.08; P<0.01) resection. Extent of surgery and any radiation treatment were determined to be important predictors of OS. The results also revealed that patient outcome was improved following any treatment compared with supportive care alone. In conclusion, multidisciplinary care is critical for the treatment of patients diagnosed with angiosarcoma.

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