title: Cutaneous angiosarcoma: a single-institution experience.
abstract: BACKGROUND
  Cutaneous angiosarcoma (CAS) is a rare, aggressive vascular sarcoma with a poor prognosis, historically associated with 5-year overall survival (OS) rates between 10 and 30 %.
  
  
  METHODS
  This is a single-institution retrospective review of patients treated for CAS from 1999-2011. Demographics, primary tumor characteristics, treatment, and outcomes were analyzed.
  
  
  RESULTS
  A total of 88 patients were identified (median age 70 years and 57 % female). Median tumor size was 3 cm. Median follow-up was 22 months. The 5-year OS and recurrence-free survival (RFS) were 35.2 and 32.3 %, respectively; median was 22.1 months. Also, 36 patients (41 %) received surgery alone, 7 (8 %) received XRT alone, and 41 (47 %) received surgery and XRT. Of the 67 of 88 patients who were disease-free after treatment, 33 (50 %) recurred (median of 12.3 months). Surgery alone had the highest 5-year OS (46.9 %) and RFS (39.9 %) (p = ns). Four presentation groups were identified: (1) XRT-induced, n = 30 (34 %), 26 of 30 occurred in females with a prior breast cancer, (2) sporadic CAS on head and neck (H/N), n = 38, (3) sporadic CAS on trunk/extremities, n = 13, and (4) Stewart-Treves n = 7. Those with trunk/extremity CAS had the highest 5-year OS (64.8 %), with H/N CAS having the worst 5-year OS (21.5 %). On MV analysis, only tumor size <5 cm correlated with improved OS (p = 0.014).
  
  
  CONCLUSIONS
  In this large series, there appears to be a better overall prognosis than historically reported, especially in Stewart-Treves and CAS on trunk or extremities. While surgery alone was associated with better OS and RFS compared with other treatment modalities, this was not statistically significant. Tumor size was a significant prognostic factor for OS.
authors.affiliation: Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Perez
authors.forename: Tapan A
authors.initials: TA
authors.lastname: Padhya
authors.forename: Jane L
authors.initials: JL
authors.lastname: Messina
authors.forename: Ryan S
authors.initials: RS
authors.lastname: Jackson
authors.forename: Ricardo J
authors.initials: RJ
authors.lastname: Gonzalez
authors.forename: Marilyn M
authors.initials: MM
authors.lastname: Bui
authors.forename: G Douglas
authors.initials: GD
authors.lastname: Letson
authors.forename: C W
authors.initials: CW
authors.lastname: Cruse
authors.forename: Robert S
authors.initials: RS
authors.lastname: Lavey
authors.forename: David
authors.initials: D
authors.lastname: Cheong
authors.forename: Meghan R
authors.initials: MR
authors.lastname: Forster
authors.forename: William J
authors.initials: WJ
authors.lastname: Fulp
authors.forename: Vernon K
authors.initials: VK
authors.lastname: Sondak
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Zager
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006394:Hemangiosarcoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D015996:Survival Rate; D055815:Young Adult