title: Angiosarcoma. A report of 67 patients and a review of the literature.
abstract: BACKGROUND
  Angiosarcomas (AS) are rare, aggressive tumors. Optimal treatment has not been well defined. The authors undertook a retrospective review of patients seen at their institution with the intent of identifying prognostic factors and optimal treatment strategies.
  
  
  METHODS
  Between 1955 and 1990, 67 patients with AS were seen at the University of California, at Los Angeles Medical Center. Follow-up ranged from 1 to 173 months with a median of 30 months.
  
  
  RESULTS
  The overall prognosis was poor. The actuarial 2- and 5-year disease free survivals (DFS) were 44% and 24%, respectively. Of 52 recurrences after primary treatment, 81% (42 of 52) had a component of local failure. Twenty-eight patients had developed distant metastases at last follow-up. Of patients who received surgery (S) and radiation therapy (RT), with or without chemotherapy (CT), 5-year actuarial DFS was 43%, compared with 17% for patients who underwent S +/- CT as initial treatment (P = 0.03). Only 9% of patients (1 of 11) treated with RT +/- CT were rendered free of disease.
  
  
  CONCLUSIONS
  Patients with AS usually present with high grade histology, and with multifocal disease. There is a propensity for both local recurrence and distant metastases. Our results and a review of the literature, suggest that S plus RT offers the best chance for long term control of this aggressive tumor. The role of CT remains undefined.
authors.affiliation: Department of Radiation Oncology, Good Samaritan Hospital, Los Angeles, California, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Mark
authors.forename: J C
authors.initials: JC
authors.lastname: Poen
authors.forename: L M
authors.initials: LM
authors.lastname: Tran
authors.forename: Y S
authors.initials: YS
authors.lastname: Fu
authors.forename: G F
authors.initials: GF
authors.lastname: Juillard
mesh_terms: D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D002648:Child; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006394:Hemangiosarcoma / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology / Q000209:etiology; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000209:etiology; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016879:Salvage Therapy; D012983:Soft Tissue Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome