Radiation-associated angiosarcoma of the breast: An international multicenter analysis

Autoři	MERGANCOVA Jana LIEROVA Anna COUFAL Oldřich ZATECKY Jan MELICHAR Bohuslav ZEDNIKOVA Ilona MERGANCOVA Jindriska JESENKOVA Anna STASTNY Karel GATEK Jiri KUBALA Otakar PROKOP Jiri DYTTERT Daniel KARABA Marian SCHWARZBACHEROVA Ivana HUMENANSKA Anna SUK Jindrich VALENTA Michal MOUCHA Vladimir SAKRA Lukas HLAVKA Ales HACOVA Maria VOJTISEK Radovan SOCHOR Marek JIRASEK Tomas ZABOJNIKOVA Michaela ZEMANOVA Martina MACHALEKOVA Katarina RUSNAKOVA Dominika KUDELOVA Eva SMOLAR Marek
Rok publikování	2022
Druh	Článek v odborném periodiku
Časopis / Zdroj	SURGICAL ONCOLOGY-OXFORD
Fakulta / Pracoviště MU	Lékařská fakulta
Citace
www	https://www.sciencedirect.com/science/article/pii/S0960740422000196?via%3Dihub
Doi	http://dx.doi.org/10.1016/j.suronc.2022.101726
Klíčová slova	Radiation; Angiosarcoma; Breast; Multicenter study
Popis	Introduction: Radiation-associated angiosarcoma (RAAS) is a rare and serious complication of breast irradiation. Due to the rarity of the condition, clinical experience is limited and publications on this topic include only retrospective studies or case reports.Materials and methods: All patients diagnosed with RAAS between January 2000 and December 2017 in twelve centers across the Czech Republic and Slovakia were evaluated.Results: Data of 53 patients were analyzed. The median age at diagnosis was 72 (range 44-89) years. The median latency period between irradiation and diagnosis of RAAS was 78 (range 36-172) months. The median radiation dose was 57.6 (range 34-66) Gy. The whole breast radiation therapy with radiation boost to the tumor bed was the most common radiotherapy regimen. Total mastectomy due to RAAS was performed in 43 patients (81%), radical excision in 8 (15%); 2 patients were not surgically treated due to unresectable disease. Adjuvant chemotherapy followed surgical therapy of RAAS in 18 patients, 3 patients underwent adjuvant radiotherapy. The local recurrence rate of RAAS was 43% and the median time from surgery to the onset of recurrence was 7.5 months (range 3-66 months). The 3-year survival rate was 56%, the 5-year survival rate was only 33%. 46% of patients died during the follow-up period.Conclusion: The present data demonstrate that RAAS is a rare condition with high local recurrence rate (43%) and mortality (the 5-year survival rate was 33%.). Early diagnosis of RAAS based on biopsy is crucial for treatment with radical intent. Surgery with negative margins constitutes the most important part of the therapy; the role of adjuvant chemotherapy and radiotherapy is still unclear.