Prognosis of Angiosarcoma at Different Anatomic Sites

Purpose:

Angiosarcomas are rare soft-tissue sarcomas of vascular endothelial origin that have a poor prognosis. Under the same pathology diagnosis of angiosacoma, the prognosis seems to be different regarding to anatomical sites. We aim to investigate the relationship between tumor/patient profile, treatments, prognosis and anatomical sites from our data base.

Materials and Methods:

From 1997 to 2011, we collect 44 patients diagnosed with angiosarcoma from database of department of pathology in two centers (Taipei Veteran General Hospital and Koo Fundation Sun Yat-Sen Cancer Center). They were divided into three groups according to anatomical sites: 1. Scalp and face, 2. Trunk, 3. Liver. By retrospective chart review, the collected data includes patient profile, tumor profile, treatment and prognosis.

Results:

24 patients have angiosarcomas at scalp and face, 9 patients have angiosarcomas at trunk (7 patients have breast angiosarcomas and all of them were non-radiation related), 11 have angiosarcomas in liver. 83.3% patients were male in scalp and face angiosarcomas group compared with 36.4% in liver group, and all patients were female in trunk group, P<0.0001. Mean age of scalp and face group was 76.58±9.353 years old, 68.36±12.948 in liver group compared with 42.33±7.794 in trunk group, P<0.0001. 66.7% patients have solitary lesions in scalp and face group, 77.8% in trunk group compared with 9.1% in liver group, P<0.0001. 79.2% patients received operation in scalp and face group, 88.9% in trunk group while only 9.1% in liver group, P<0.0001. 5-year survival was 8.3% in scalp and face group, 64.8% in trunk group and 0 in liver group.

Conclusion:

Scalp and face angiosarcomas are more common in old male patients, more difficult to reach free margin status, more likely to recur locally and metastasize distantly with poor prognosis, and flaps or grafts were needed for reconstruction after resection. Trunk (breast) angiosarcomas are more common in middle-aged women, usually solitary but bigger in size and easier to reach free margin status, with better prognosis and survival. Patients with liver angiosarcomas often had multifocal lesions, less resectable and with the worst prognosis.