TY - JOUR
T1 - Long-term outcomes in patients with radiation-associated angiosarcomas of the breast following surgery and radiotherapy for breast cancer
AU - Torres, Keila E.
AU - Ravi, Vinod
AU - Kin, Katherine
AU - Yi, Min
AU - Guadagnolo, B. Ashleigh
AU - May, Caitlin D.
AU - Arun, Banu K.
AU - Hunt, Kelly K.
AU - Lam, Ryan
AU - Lahat, Guy
AU - Hoffman, Aviad
AU - Cormier, Janice N.
AU - Feig, Barry W.
AU - Lazar, Alexander J.
AU - Lev, Dina
AU - Pollock, Raphael E.
N1 - Funding Information:
ACKNOWLEDGMENT We thank Sarah Taylor for generous assistance in the identification of cases. This work was supported in part by the Sarcoma Alliance for Research through Collaboration.
PY - 2013/4
Y1 - 2013/4
N2 - Background: Radiation-associated angiosarcoma (RAAS) is a devastating disease occasionally observed in breast cancer patients treated with radiation. Due to its rarity, our knowledge-of disease risk factors, epidemiology, treatment, and outcome-is extremely limited. Therefore, we sought to identify clinicopathologic factors associated with local and distant recurrence and disease-specific survival (DSS). Methods: Radiation-associated angiosarcoma was defined as pathologically confirmed breast or chest wall angiosarcoma arising within a previously irradiated field. A comprehensive search of our institutional tumor registry (1/1/93 through 2/28/11) was used to identify patients (n = 95 females). Patient, original tumor, RAAS treatment, and outcome variables were retrospectively retrieved and assembled into a database. Results: The median follow-up for all RAAS patients was 10.3 (range, 2.4-31.8) years. The latency period following radiation exposure ranged from 1.4 to 26 (median, 7) years. One-year and 5-year DSS rates were 93.5 and 62.6 %, respectively. Reduced risk of local recurrence was observed in patients who received chemotherapy (P = 0.0003). In multivariable analysis, size was found to be an independent predictor of adverse outcome (P = 0.015). Conclusions: Our study demonstrates that RAAS exhibits high recurrence rates. It also highlights the need for well-designed, multicenter, clinical trials to inform the true utility of chemotherapy in this disease.
AB - Background: Radiation-associated angiosarcoma (RAAS) is a devastating disease occasionally observed in breast cancer patients treated with radiation. Due to its rarity, our knowledge-of disease risk factors, epidemiology, treatment, and outcome-is extremely limited. Therefore, we sought to identify clinicopathologic factors associated with local and distant recurrence and disease-specific survival (DSS). Methods: Radiation-associated angiosarcoma was defined as pathologically confirmed breast or chest wall angiosarcoma arising within a previously irradiated field. A comprehensive search of our institutional tumor registry (1/1/93 through 2/28/11) was used to identify patients (n = 95 females). Patient, original tumor, RAAS treatment, and outcome variables were retrospectively retrieved and assembled into a database. Results: The median follow-up for all RAAS patients was 10.3 (range, 2.4-31.8) years. The latency period following radiation exposure ranged from 1.4 to 26 (median, 7) years. One-year and 5-year DSS rates were 93.5 and 62.6 %, respectively. Reduced risk of local recurrence was observed in patients who received chemotherapy (P = 0.0003). In multivariable analysis, size was found to be an independent predictor of adverse outcome (P = 0.015). Conclusions: Our study demonstrates that RAAS exhibits high recurrence rates. It also highlights the need for well-designed, multicenter, clinical trials to inform the true utility of chemotherapy in this disease.
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U2 - 10.1245/s10434-012-2755-y
DO - 10.1245/s10434-012-2755-y
M3 - Article
C2 - 23224828
AN - SCOPUS:84875209225
SN - 1068-9265
VL - 20
SP - 1267
EP - 1274
JO - Annals of surgical oncology
JF - Annals of surgical oncology
IS - 4
ER -