Malignant vascular tumors: clinical presentation, surgical therapy, and long-term prognosis.
BACKGROUND
The aim of this study was to analyze the presentation of, surgery for, and prognosis of malignant vascular tumors (MVTs).


METHODS
This was an observational single-center study. Patients who underwent operation for MVTs between 1988 and 2004 were included. Data were gathered prospectively in a computerized registry.


RESULTS
Of 568 adult patients with soft tissue malignancies, 43 (7.6%) were treated for MVTs. Twenty-four men and 19 women (median age, 55.3 years) were referred for 30 primary tumors and 13 recurrences. Symptoms were observed in 90.7% of the cases (swelling [37.2%], pain [34.9%], extrusion [11.6%], hemorrhage [7%], weight loss [4.7%], loss of energy [4.7%], impaired function [4.7%], and others [30.2%]). Tumors were located in the extremities (n = 16), trunk (n = 3), abdomen (n = 15), retroperitoneum (n = 7), and thyroid gland (n = 2). Twenty-two (51.2%) angiosarcomas, nine (20.9%) malignant hemangiopericytomas, eight (18.6%) malignant epithelioid hemangioendotheliomas, and four (9.3%) lymphangiosarcomas were seen. The median overall survival after surgery was 21.4 months, with 2-, 5-, and 10-year overall survival rates of 41.5%, 38.3%, and 18.8%, respectively. MVTs of the extremities and trunk and localized disease indicated a better prognosis than abdominal or retroperitoneal MVTs (univariate and multivariate analyses: P = .0122 and P = .0287) and metastasized stages (univariate and multivariate analyses: P = .0187 and P = .0287).


CONCLUSIONS
A considerable number of patients with soft tissue malignancies undergo surgery for MVT. Various symptoms and a multilocular occurrence are typical. The course of MVTs is aggressive. Tumor site and stage are important prognostic factors. Surgery is potentially curative, especially for localized disease of the extremities and trunk.
Leowardi
Christine
C
Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, Heidelberg 69120, Germany.
Hinz
Ulf
U
Hormann
Yura
Y
Wente
Moritz N
MN
Mechtersheimer
Gunhild
G
Willeke
Frank
F
Böckler
Dittmar
D
Friess
Helmut
H
Allenberg
Jens-Rainer
JR
Herfarth
Christian
C
Büchler
Markus W
MW
Schwarzbach
Matthias H M
MH
D000328:Adult; D000368:Aged; D005260:Female; D018323:Hemangioendothelioma, Epithelioid / Q000175:diagnosis / Q000601:surgery; D006393:Hemangiopericytoma / Q000175:diagnosis / Q000601:surgery; D006394:Hemangiosarcoma / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D019043:Vascular Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery