ANGIOSARCOMA - A REPORT OF 67 PATIENTS AND A REVIEW OF THE LITERATURE

BACKGROUND. Angiosarcomas (AS) are rare, aggressive tumors. Optimal tr eatment has not been well defined. The authors undertook a retrospecti ve review of patients seen at their institution with the intent of ide ntifying prognostic factors and optimal treatment strategies. METHODS. Between 1955 and 1990, 67 patients with AS were seen at the Universit y of California, at Los Angeles Medical Center. Follow-up ranged from 1 to 173 months with a median of 30 months. RESULTS. The overall progn osis was poor. The actuarial 2- and 5-year disease free survivals (DFS ) were 44% and 24%, respectively. Of 52 recurrences after primary trea tment, 81% (42 of 52) had a component of local failure. Twenty-eight p atients had developed distant metastases at last follow-up. Of patient s who received sur gery (S) and radiation therapy (RT), with or withou t chemotherapy (CT), 5-year actuarial DFS was 43%, compared with 17% f or patients who underwent S+/-CT as initial treatment (P = 0.03). Only 9% of patients (1 of 11) treated with RT+/-CT were rendered free of d isease. CONCLUSIONS. Patients with AS usually present with high grade histology, and with multifocal disease. There is a propensity for both local recurrence and distant metastases. Our results and a review of the literature, suggest that S plus RT offers the best chance for long term control of this aggressive tumor. The role of CT remains undefin ed. (C) 1996 American Cancer Society.