目的:本研究旨在探讨血管肉瘤(AS)患者的肿瘤结局和预后因素。
方法:这种单中心,回顾性队列研究,分析组织病理学证实的AS病例。初步诊断,包括局部复发和转移性AS。总生存期(OS),通过Kaplan-Meier估计器评估局部控制(LC)和局部无进展生存期(LPFS).多变量Cox回归分析检测与OS和LPFS相关的因素。
结果:总计,纳入118例中位随访6.6个月的患者。大多数患者出现局部疾病(62.7%),其次是转移性(31.4%)和局部复发(5.9%)。74名病人(62.7%)接受手术,其中29人(39.2%)只接受手术治疗,38例(51.4%)接受手术和围手术期放疗或化疗,和7(9.4%)手术,围手术期放疗和化疗。OS的多变量Cox回归显示与年龄(风险比(HR):1.03,p=0.044)和转移疾病(风险比:3.24,p=0.015)显着相关。对于LPFS,年龄每年(HR:1.04,p=0.008),报告时局部复发性疾病(HR:5.32,p=0.013),和转移性疾病(HR:4.06,p=0.009)存在显着相关性。肿瘤大小,上皮样成分,边距状态,围手术期RT和/或CTX与OS或LPFS无显著相关性。
结论:初始表现状态的年龄和转移性疾病与OS和LPFS呈负相关。通过收集多机构数据集来克服AS的流行病学挑战,有必要进行创新和协作。对AS进行分子表征并确定新的围手术期治疗方法以改善患者预后。
OBJECTIVE: This study sought to investigate oncological outcomes and prognostic factors for patients with angiosarcomas (AS).
METHODS: This single-center, retrospective cohort study, analyzed histopathologically confirmed AS cases. Primarily diagnosed, locally recurrent and metastatic AS were included. Overall survival (OS), local control (LC) and local progression-free survival (LPFS) were assessed by Kaplan-Meier estimator. Multivariable Cox regression analysis was performed to detect factors associated with OS and LPFS.
RESULTS: In total, 118 patients with a median follow-up of 6.6 months were included. The majority presented with localized disease (62.7%), followed by metastatic (31.4%) and locally recurrent (5.9%) disease. Seventy-four patients (62.7%) received surgery, of which 29 (39.2%) were treated with surgery only, 38 (51.4%) with surgery and perioperative radiotherapy or chemotherapy, and 7 (9.4%) with surgery, perioperative radiotherapy and chemotherapy. Multivariable Cox regression of OS showed a significant association with age per year (hazard ratio (HR): 1.03, p = 0.044) and metastatic disease at presentation (hazard ratio: 3.24, p = 0.015). For LPFS, age per year (HR: 1.04, p = 0.008), locally recurrent disease at presentation (HR: 5.32, p = 0.013), and metastatic disease at presentation (HR: 4.06, p = 0.009) had significant associations. Tumor size, epithelioid components, margin status, and perioperative RT and/or CTX were not significantly associated with OS or LPFS.
CONCLUSIONS: Older age and metastatic disease at initial presentation status were negatively associated with OS and LPFS. Innovative and collaborative effort is warranted to overcome the epidemiologic challenges of AS by collecting multi-institutional datasets, characterizing AS molecularly and identifying new perioperative therapies to improve patient outcomes.