title: Angiosarcoma outcomes and prognostic factors: a 25-year single institution experience.
abstract: OBJECTIVE
  Angiosarcoma is an aggressive malignancy with endothelial differentiation and notoriously poor prognosis despite aggressive therapy. Limited data are available to guide management decisions. To address this limitation, we present a large retrospective analysis of angiosarcoma patients treated at a single institution over a 25-year period.
  
  
  METHODS
  To identify factors that impact angiosarcoma outcomes, we reviewed demographic, tumor, and treatment characteristics of angiosarcoma patients evaluated at the University of Wisconsin Hospital between 1987 and 2012.
  
  
  RESULTS
  The cohort included 81 patients diagnosed at ages 19 to 90 years (median, 67 y). Fifty-five (68%) patients presented with localized disease, whereas 26 (32%) presented with metastases. The primary sites were visceral/deep soft tissue (42%), head and neck/cutaneous (37%), breast (16%), and limbs in the setting of Stewart-Treves (5%). The 5-year overall survival was 40% with a median of 16 months. By univariate analysis, significant adverse predictors of survival included metastases at presentation, visceral/deep soft tissue tumor location, tumor size > 5 cm, tumor necrosis, and the absence of surgical excision. A trend toward prolonged survival was observed with radiation therapy and for chemotherapy in patients with metastases. Age, sex, and prior radiation showed no correlation with survival.
  
  
  CONCLUSIONS
  Our large single institution series confirms the poor prognosis of angiosarcoma, supports a central role for surgical excision in management, and highlights the need for novel therapies particularly in patients who present with metastatic disease.
authors: Departments of *Pathology †Human Oncology §Medicine ∥Dermatology, University of Wisconsin, School of Medicine and Public Health, Madison, WI ‡Moses Cone Regional Cancer Center, Greensboro, NC.
authors: Darya
authors: D
authors: Buehler
authors: Stephanie R
authors: SR
authors: Rice
authors: John S
authors: JS
authors: Moody
authors: Patrick
authors: P
authors: Rush
authors: Gholam-Reza
authors: GR
authors: Hafez
authors: Steven
authors: S
authors: Attia
authors: B Jack
authors: BJ
authors: Longley
authors: Kevin R
authors: KR
authors: Kozak
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006394:Hemangiosarcoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D015996:Survival Rate; D014922:Wisconsin; D055815:Young Adult