open access publication

Article, 2024

A Population-Based Long-Term Follow-Up of Soft Tissue Angiosarcomas: Characteristics, Treatment Outcomes, and Prognostic Factors

Cancers, ISSN 2072-6694, Volume 16, 10, Page 1834, 10.3390/cancers16101834

Contributors

Holm, Christina Enciso (Corresponding author) [1] [2] [3] Ørholt, Mathias 0000-0002-8815-8392 [1] [2] [4] Talman, Maj-Lis Møller [1] [2] Abebe, Kiya [1] [2] [4] Thorn, Andrea Pohly Jeppesen 0000-0003-3761-2791 [1] [2] [3] Baad-Hansen, Thomas 0000-0003-4826-8412 [5] Petersen, Michael Mørk 0000-0002-2324-6420 [1] [2] [3]

Affiliations

  1. [1] Rigshospitalet
    2. [NORA names: Capital Region of Denmark; Hospital; Denmark; Europe, EU; Nordic; OECD];
  2. [2] University of Copenhagen
    3. [NORA names: KU University of Copenhagen; University; Denmark; Europe, EU; Nordic; OECD];
  3. [3] Department of Orthopedic Surgery, Rigshospitalet, University of Copenhagen, Blegdamsvej 3, 2100 Copenhagen, Denmark;, andrea.pohly.jeppesen.thorn@regionh.dk, (A.T.);, michael.moerk.petersen@regionh.dk, (M.M.P.)
  4. [4] Department of Plastic Surgery and Burns Treatment, Rigshospitalet, University of Copenhagen, Blegdamsvej 3, 2100 Copenhagen, Denmark;, mathias.oerholt.nielsen@regionh.dk, (M.Ø.);, kiya.abebe.01@regionh.dk, (K.A.)
  5. [5] Aarhus University Hospital
    6. [NORA names: Central Denmark Region; Hospital; Denmark; Europe, EU; Nordic; OECD]

Abstract

Angiosarcoma is a rare aggressive and understudied soft tissue sarcoma with pending evidence-based treatment guidelines due to varying study cohorts and inconsistent outcome measures. Surgery with wide resection is currently considered to be the cornerstone in management. In a population-based cohort identified from Danish National Health Registers between 2000 and 2017, this study aimed to define prognostic factors in patients with newly diagnosed soft tissue angiosarcoma. Kaplan-Meier survival analysis demonstrated 5-year overall survival of 28%. Competing risk analysis demonstrated cumulative incidence of local recurrence of 30% and metastasis of 43%. Multivariable Cox models among 154 included patients demonstrated age above 60 years and metastasis to be independently associated with worse overall survival. Cutaneous tumors, surgery, and negative resection margin were independently associated with improved overall survival. Adjuvant oncological treatment did not improve overall survival, risk of metastasis, or recurrence. Negative margin was not associated with lower risk of recurrence and metastasis. We conclude that, despite demonstrated improved survival after surgery with wide resection, overall survival remains poor.

Keywords

Competing risk analysis, Cox model, Danish, Danish national health registers, Kaplan-Meier survival analysis, adjuvant oncological treatment, age, analysis, angiosarcoma, associated with improved overall survival, associated with lower risk, associated with worse overall survival, characteristics, cohort, cornerstone, cumulative incidence, cumulative incidence of local recurrence, cutaneous tumors, evidence-based treatment guidelines, factors, guidelines, health registers, improved overall survival, improved survival, incidence of local recurrence, inconsistent outcome measures, local recurrence, low risk, management, margin, measurements, metastasis, model, multivariate Cox model, national health registers, negative margins, negative resection margins, oncological treatment, outcome measures, outcomes, overall survival, patients, population-based cohort, prognostic factors, recurrence, register, resection, resection margins, risk, risk analysis, risk of metastasis, sarcoma, soft tissue angiosarcoma, soft tissue sarcomas, softness, study, study cohort, surgery, survival, survival analysis, tissue sarcomas, treatment, treatment guidelines, treatment outcomes, tumor, wide resection, years

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