Angiosarcoma outcomes and prognostic factors: a 25-year single institution experience

Am J Clin Oncol. 2014 Oct;37(5):473-9. doi: 10.1097/COC.0b013e31827e4e7b.


Objective: Angiosarcoma is an aggressive malignancy with endothelial differentiation and notoriously poor prognosis despite aggressive therapy. Limited data are available to guide management decisions. To address this limitation, we present a large retrospective analysis of angiosarcoma patients treated at a single institution over a 25-year period.

Methods: To identify factors that impact angiosarcoma outcomes, we reviewed demographic, tumor, and treatment characteristics of angiosarcoma patients evaluated at the University of Wisconsin Hospital between 1987 and 2012.

Results: The cohort included 81 patients diagnosed at ages 19 to 90 years (median, 67 y). Fifty-five (68%) patients presented with localized disease, whereas 26 (32%) presented with metastases. The primary sites were visceral/deep soft tissue (42%), head and neck/cutaneous (37%), breast (16%), and limbs in the setting of Stewart-Treves (5%). The 5-year overall survival was 40% with a median of 16 months. By univariate analysis, significant adverse predictors of survival included metastases at presentation, visceral/deep soft tissue tumor location, tumor size > 5 cm, tumor necrosis, and the absence of surgical excision. A trend toward prolonged survival was observed with radiation therapy and for chemotherapy in patients with metastases. Age, sex, and prior radiation showed no correlation with survival.

Conclusions: Our large single institution series confirms the poor prognosis of angiosarcoma, supports a central role for surgical excision in management, and highlights the need for novel therapies particularly in patients who present with metastatic disease.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Hemangiosarcoma / mortality
  • Hemangiosarcoma / pathology*
  • Hemangiosarcoma / therapy
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Soft Tissue Neoplasms / mortality
  • Soft Tissue Neoplasms / pathology*
  • Soft Tissue Neoplasms / therapy
  • Survival Rate
  • Wisconsin
  • Young Adult