title: Challenges in the treatment of angiosarcoma: a single institution experience.
abstract: BACKGROUND
  Angiosarcomas are rare tumors that carry poor prognosis. Because of insidious growth rate, the diagnosis is often difficult and delayed.
  
  
  METHODS
  Between 1990 and 2011, 72 (41 female, 31 male) patients were treated at our institution. Pathologic confirmation was obtained and multiple prognostic factors were evaluated for survival.
  
  
  RESULTS
  Forty-four cases were sporadic and 28 cases were secondary. In the sporadic group, 16 (36%) patients had increased sun exposure, while in the secondary group, the majority (n = 23, 82%) of patients had prior exposure to radiation. The latent period between radiation exposure and diagnosis was predictive of survival (P = .037). Presentation was delayed by more than 3 months in 41% of patients. The majority of men developed head and neck angiosarcomas (n = 15, 48.5%), while women developed breast angiosarcomas (n = 21, 51%). Median survival was prolonged in patients treated initially with surgery.
  
  
  CONCLUSIONS
  A delay in the diagnosis of angiosarcoma can affect survival. Clinical suspicion and prompt diagnosis are essential for successful multimodal therapy. Initial surgical resection with adjuvant chemotherapy provides survival advantage.
authors.affiliation: Department of Surgery, Temple University Hospital, 3401 N. Broad Street, 4th Floor Parkinson Pavilion, Philadelphia, PA 19140, USA.
authors.forename: Smit
authors.initials: S
authors.lastname: Singla
authors.affiliation: Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA.
authors.forename: Pavlos
authors.initials: P
authors.lastname: Papavasiliou
authors.affiliation: Department of Surgery, Temple University Hospital, 3401 N. Broad Street, 4th Floor Parkinson Pavilion, Philadelphia, PA 19140, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Powers
authors.affiliation: Department of Surgery, Temple University Hospital, 3401 N. Broad Street, 4th Floor Parkinson Pavilion, Philadelphia, PA 19140, USA.
authors.forename: John
authors.initials: J
authors.lastname: Gaughan
authors.affiliation: Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: von Mehren
authors.affiliation: Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA.
authors.forename: James C
authors.initials: JC
authors.lastname: Watson
authors.affiliation: Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA. Electronic address: jeffrey.farma@fccc.edu.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Farma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000401:mortality*; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy; D006394:Hemangiosarcoma / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D055815:Young Adult
keywords: Angiosarcoma; Chemotherapy; Radiation; Surgery