Department of Plastic Surgery, Royal Victoria Infirmary, Queen Victoria Road, Newcastle-Upon-Tyne, NE1 4LP, UK.
J Plast Reconstr Aesthet Surg. 2011 Jul;64(7):884-91. doi: 10.1016/j.bjps.2010.11.016. Epub 2010 Dec 9.
Angiosarcomas are rare aggressive sarcomas of vascular endothelial origin. These tumours have the potential to be multicentric and are associated with high rates of local recurrence, which makes treatment challenging. The gold-standard is that these patients are managed in specialist centres by a multidisciplinary team. We present our experience of managing patients with angiosarcoma in the North of England Bone and Soft Tissue Tumour Service and a review of the literature.
A prospectively collated electronic database was used to identify patients with angiosarcoma treated between 2000 and 2008, and an analysis performed of demographics, anatomical site, surgical excision and reconstruction, local disease recurrence and metastatic disease.
Fifteen patients (ten female, five male, mean age 71 years) were identified. Eight patients developed tumours in a previously irradiated area, after a mean of 11 years. Six patients had metastatic disease at presentation. Fourteen patients underwent wide surgical excision of the tumour, of which nine required defect reconstruction (five free latissimus dorsi flaps, two free anterolateral thigh flaps, two pedicled latissimus dorsi flaps). One patient was treated with chemotherapy only. Five of 14 patients received adjuvant radiotherapy, and one received adjuvant chemotherapy. Two out of 14 patients developed local recurrence. Eight patients developed metastases, the majority of which were pulmonary. Estimated five-year survival was calculated as 33% in our patient cohort.
Angiosarcomas are aggressive, difficult to treat tumours, which can occur secondary to a multitude of causes. Clinical suspicion, biopsy and early diagnosis are essential to allow optimum treatment, which currently consists of radical surgery, together with adjuvant radiotherapy and chemotherapy.
血管肉瘤是一种罕见的、来源于血管内皮的侵袭性肉瘤。这些肿瘤具有多中心性的潜力，且局部复发率高，这使得治疗极具挑战性。这些患者应在多学科团队的专业中心进行管理，这是金标准。我们展示了在英格兰北部骨与软组织肿瘤服务中心管理血管肉瘤患者的经验，并对文献进行了回顾。
使用前瞻性收集的电子数据库来确定 2000 年至 2008 年期间治疗的血管肉瘤患者，并对患者的人口统计学、解剖部位、手术切除和重建、局部疾病复发和转移性疾病进行分析。
共确定了 15 名患者（10 名女性，5 名男性，平均年龄 71 岁）。8 名患者在平均 11 年后于先前接受过放射治疗的区域发生肿瘤。6 名患者在就诊时已发生转移性疾病。14 名患者接受了肿瘤的广泛切除术，其中 9 名需要进行缺陷重建（5 名游离背阔肌皮瓣，2 名游离股前外侧皮瓣，2 名带蒂背阔肌皮瓣）。1 名患者仅接受化疗。14 名患者中有 5 名接受了辅助放疗，1 名接受了辅助化疗。14 名患者中有 2 名发生局部复发。8 名患者发生了转移，其中大多数是肺部转移。在我们的患者队列中，估计五年生存率为 33%。
血管肉瘤是一种侵袭性强、难以治疗的肿瘤，可由多种原因引起。临床怀疑、活检和早期诊断对于获得最佳治疗至关重要，目前的治疗方法包括根治性手术，以及辅助放疗和化疗。
