title: Primary and Secondary Soft Tissue Angiosarcomas: Prognostic Significance of Surgical Margins in 43 Patients.
abstract: BACKGROUND
  Angiosarcomas are aggressive soft tissue sarcomas. Due to their rarity there is a paucity of data regarding the clinical outcome of patients with non-visceral angiosarcomas of the soft tissues. In particular, the prognostic significance of surgical margins remains controversial.
  
  
  METHODS
  We retrospectively assessed the outcome of 43 patients with localised disease suitable for surgical treatment with curative intent. The median follow-up was 7.5 years.
  
  
  RESULTS
  The 5-year overall survival (OS) rate was 46.2%. Sixteen patients (37.2%) were diagnosed with secondary, radiation-induced angiosarcomas. Twenty-four patients (55.8%) developed local recurrences and 15 patients (34.9%) distant metastases. Negative surgical margin emerged as the only statistically significant prognostic factor (5-year OS: R0 51.8% vs. R1/R2 17.1%, p=0.036). As indicated in the regression analysis, close and wide negative margins within the R0 subgroup led to similar outcomes.
  
  
  CONCLUSIONS
  Angiosarcomas have a high risk of local recurrence and metastasis. Surgical resection with negative margins improves the outcome.
authors.affiliation: Department of Plastic Surgery, BG-University Hospital Bergmannsheil, Bochum, Germany kamran.harati@t-online.de.
authors.forename: Kamran
authors.initials: K
authors.lastname: Harati
authors.affiliation: Department of Plastic Surgery, BG-University Hospital Bergmannsheil, Bochum, Germany.
authors.forename: Adrien
authors.initials: A
authors.lastname: Daigeler
authors.affiliation: Department of Plastic Surgery, BG-University Hospital Bergmannsheil, Bochum, Germany.
authors.forename: Ole
authors.initials: O
authors.lastname: Goertz
authors.affiliation: Department of Plastic Surgery, BG-University Hospital Bergmannsheil, Bochum, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Böhm
authors.affiliation: Department of Plastic Surgery, BG-University Hospital Bergmannsheil, Bochum, Germany.
authors.forename: Kim
authors.initials: K
authors.lastname: Lange
authors.affiliation: Institute of Pathology, Ruhr-University Bochum, Bochum, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Stricker
authors.affiliation: Department of Plastic Surgery, BG-University Hospital Bergmannsheil, Bochum, Germany.
authors.forename: Jonas
authors.initials: J
authors.lastname: Kolbenschlag
authors.affiliation: Department of Plastic Surgery, BG-University Hospital Bergmannsheil, Bochum, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Lehnhardt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006394:Hemangiosarcoma / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D012509:Sarcoma / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Angiosarcoma; margin; recurrence; resection; survival