Smrke Alannah, Hamm Jeremy, Karvat Anand, Simmons Christine, Srikanthan Amirrtha
Department of Medical Oncology, BC Cancer, Vancouver Centre, Vancouver, BC V5Z4E6, Canada.
Department of Cancer Surveillance Outcomes, BC Cancer, Vancouver Centre, Vancouver, BC V5Z4E6, Canada.
Mol Clin Oncol. 2020 Aug;13(2):179-185. doi: 10.3892/mco.2020.2055. Epub 2020 Jun 2.
Angiosarcoma is a subset of soft-tissue sarcomas with poor 5-year survival rate. Given its rarity, limited large cohort data is available for this disease. Therefore, the present study evaluated data from patients with angiosarcoma treated at a provincial Institution (BC Cancer) to determine potential modifiable predictors of survival. A retrospective review of patients across British Columbia (Canada) was conducted at the Sarcoma Outcome Unit of BC Cancer from January 1, 1969 to September 19, 2017. Cox proportional hazard models were used to calculate hazard ratios (HR) for the overall survival (OS) and progression free survival (PFS) of patients. A total of 145 patients with angiosarcoma were identified, of which 68 were metastatic/unresectable at presentation. Of the 145 patients included, 38 received chemotherapy, with 15 receiving taxane. A single patient received chemotherapy in a neoadjuvant setting. Of the resectable patients, 71 had first line surgery and 38 had curative-intent radiation during their treatment. Of the study cohort, 38 patients received prior radiation for an unrelated cancer and 4 patients had pre-existing chronic lymphedema. Resectable disease (HR, 0.22; P<0.01), first treatment with either surgery (HR, 0.08; P<0.01), radiation (HR, 0.19; P<0.01) or chemotherapy (HR, 0.22; P<0.01) were predictors of improved OS. First line surgery resulted in improved OS (HR, 0.36; P<0.01) and PFS (HR, 0.48; P<0.01). In addition, OS was positively impacted by the extent of surgery [complete (R0) vs. microscopic residual tumor (R1); HR, 0.26; P<0.01; R0 vs. macroscopic residual tumor (R2); HR, 0.08; P<0.01) resection. Extent of surgery and any radiation treatment were determined to be important predictors of OS. The results also revealed that patient outcome was improved following any treatment compared with supportive care alone. In conclusion, multidisciplinary care is critical for the treatment of patients diagnosed with angiosarcoma.
血管肉瘤是软组织肉瘤的一个子集，5年生存率较低。鉴于其罕见性，关于这种疾病的大型队列数据有限。因此，本研究评估了在一家省级机构（卑诗省癌症机构）接受治疗的血管肉瘤患者的数据，以确定潜在的可改变的生存预测因素。对加拿大不列颠哥伦比亚省的患者进行了回顾性研究，研究对象为1969年1月1日至2017年9月19日在卑诗省癌症机构肉瘤结局科接受治疗的患者。使用Cox比例风险模型计算患者总生存期（OS）和无进展生存期（PFS）的风险比（HR）。共识别出145例血管肉瘤患者，其中68例在初诊时已发生转移/无法切除。在纳入的145例患者中，38例接受了化疗，其中15例接受了紫杉烷治疗。1例患者在新辅助治疗中接受了化疗。在可切除的患者中，71例接受了一线手术，38例在治疗期间接受了根治性放疗。在研究队列中，38例患者曾因其他癌症接受过放疗，4例患者存在既往慢性淋巴水肿。可切除疾病（HR，0.22；P<0.01）、首次接受手术（HR，0.08；P<0.01）、放疗（HR，0.19；P<0.01）或化疗（HR，0.22；P<0.01）是OS改善的预测因素。一线手术可改善OS（HR，0.36；P<0.01）和PFS（HR，0.48；P<0.01）。此外，手术范围[完全切除（R0）与微小残留肿瘤（R1）；HR, 0.26；P<0.01；R0与肉眼残留肿瘤（R2）；HR, 0.08；P<0.01]对OS有积极影响。手术范围和任何放疗被确定为OS的重要预测因素。结果还显示，与单纯支持治疗相比，任何治疗后患者的预后均有所改善。总之，多学科护理对于诊断为血管肉瘤的患者的治疗至关重要。
