1. Localised angiosarcomas: the identification of prognostic factors and analysis of treatment impact. A retrospective analysis from the French Sarcoma Group (GSF/GETO).
- Author
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Lindet C, Neuville A, Penel N, Lae M, Michels JJ, Trassard M, Terrier P, Birtwisle-Peyrottes I, Valo I, Collin F, Chateau MC, Robin YM, and Coindre JM
- Subjects
- Adult, Age Factors, Aged, Aged, 80 and over, Female, France, Hemangiosarcoma drug therapy, Humans, Kaplan-Meier Estimate, Lymphedema pathology, Male, Middle Aged, Neoadjuvant Therapy, Prognosis, Retrospective Studies, Survival Analysis, Treatment Outcome, Young Adult, Hemangiosarcoma pathology, Hemangiosarcoma therapy
- Abstract
Background: Angiosarcomas represent less than 2% of all adult soft tissue sarcomas. Prognostic factors and the role of (neo-) adjuvant treatments in the management of localised angiosarcomas require further investigation., Methods: We have conducted a retrospective multicenter study (June 1980 to October 2009) of 107 patients with localised angiosarcomas. All of the cases were centrally reviewed by a certified pathologist. Univariate and multivariate analyses were conducted to identify independent poor prognostic factors (PF). Overall survival (OS) and Local Recurrence-Free Survival (LRFS) were estimated using the Kaplan-Meier method. The effect of treatments was explored using the Cox model after adjusting for the PF., Results: The median age was 71 years. 22.4% and 62.6% developed an angiosarcoma in pre-existing lymphoedema and within irradiated tissue respectively. The median OS, LRFS and Disease Recurrence-Free Survival (DRFS) were 38.8, 27 and 36.1 months, respectively. In multivariate analysis, the following parameters influenced the OS: lymphoedema (Hazard ratio (HR)=2.0) and size >5cm (HR=1.5). After adjustment to these PF, R0 margins was the only treatment parameter that improving the OS (HR=0.2). In the multivariate analysis, the LRFS was influenced by an age >70 (HR=1.8) and pre-existing lymphoedema (HR=2.0). After adjustment for these PF, R0 margins (HR=0.5) and adjuvant radiotherapy (HR=0.3) improved the LRFS., Conclusions: Our results suggest the following points: (i) pre-existing lymphoedema, tumour size and age >70 are probably the major prognostic factors in patients with localised angiosarcomas; (ii) the achievement of R0 margins is probably of major importance for improving the patient outcome and (iii) adjuvant radiotherapy probably decreased the risk of local recurrence., (Copyright © 2012 Elsevier Ltd. All rights reserved.)
- Published
- 2013
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