Localised angiosarcomas: The identification of prognostic factors and analysis of treatment impact. A retrospective analysis from the French Sarcoma Group (GSF/GETO)
Identifieur interne : 003C74 ( Main/Curation ); précédent : 003C73; suivant : 003C75Localised angiosarcomas: The identification of prognostic factors and analysis of treatment impact. A retrospective analysis from the French Sarcoma Group (GSF/GETO)
Auteurs : Clothilde Lindet [France] ; Agnès Neuville [France] ; Nicolas Penel [France] ; Marick Lae [France] ; Jean-Jacques Michels [France] ; Martine Trassard [France] ; Philippe Terrier [France] ; Isabelle Birtwisle-Peyrottes [France] ; Isabelle Valo [France] ; Françoise Collin [France] ; Marie-Christine Chateau [France] ; Yves-Marie Robin [France] ; Jean-Michel Coindre [France]Source :
- European journal of cancer : (1990) [ 0959-8049 ] ; 2013.
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Abstract
Background: Angiosarcomas represent less than 2% of all adult soft tissue sarcomas. Prognostic factors and the role of (neo-) adjuvant treatments in the management of localised angiosarcomas require further investigation. Methods: We have conducted a retrospective multicenter study (June 1980 to October 2009) of 107 patients with localised angiosarcomas. All of the cases were centrally reviewed by a certified pathologist. Univariate and multivariate analyses were conducted to identify independent poor prognostic factors (PF). Overall survival (OS) and Local Recurrence-Free Survival (LRFS) were estimated using the Kaplan-Meier method. The effect of treatments was explored using the Cox model after adjusting for the PF. Results: The median age was 71 years. 22.4% and 62.6% developed an angiosarcoma in pre-existing lymphoedema and within irradiated tissue respectively. The median OS, LRFS and Disease Recurrence-Free Survival (DRFS) were 38.8, 27 and 36.1 months, respectively. In multivariate analysis, the following parameters influenced the OS: lymphoedema (Hazard ratio (HR) = 2.0) and size >5 cm (HR = 1.5). After adjustment to these PF, RO margins was the only treatment parameter that improving the OS (HR = 0.2). In the multivariate analysis, the LRFS was influenced by an age >70 (HR = 1.8) and pre-existing lymphoedema (HR = 2.0). After adjustment for these PF, RO margins (HR = 0.5) and adjuvant radiotherapy (HR = 0.3) improved the LRFS. Conclusions: Our results suggest the following points: (i) pre-existing lymphoedema, tumour size and age >70 are probably the major prognostic factors in patients with localised angiosarcomas ; (ii) the achievement of RO margins is probably of major importance for improving the patient outcome and (iii) adjuvant radiotherapy probably decreased the risk of local recurrence.
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Localised angiosarcomas: The identification of prognostic factors and analysis of treatment impact. A retrospective analysis from the French Sarcoma Group (GSF/GETO)</title><author><name sortKey="Lindet, Clothilde" sort="Lindet, Clothilde" uniqKey="Lindet C" first="Clothilde" last="Lindet">Clothilde Lindet</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of General Oncology, Oscar Lambret Cancer Center, 3 Rue Combemale</s1><s2>59020 Lille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Hauts-de-France</region><region type="old region" nuts="2">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Neuville, Agnes" sort="Neuville, Agnes" uniqKey="Neuville A" first="Agnès" last="Neuville">Agnès Neuville</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Pathology, Institut Bergonie, 229 Cours Argonne</s1><s2>33000 Bordeaux</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Nouvelle-Aquitaine</region><region type="old region" nuts="2">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Penel, Nicolas" sort="Penel, Nicolas" uniqKey="Penel N" first="Nicolas" last="Penel">Nicolas Penel</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of General Oncology, Oscar Lambret Cancer Center, 3 Rue Combemale</s1><s2>59020 Lille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Hauts-de-France</region><region type="old region" nuts="2">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Lae, Marick" sort="Lae, Marick" uniqKey="Lae M" first="Marick" last="Lae">Marick Lae</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Department of Pathology, Institut Curie, 26 Rue d'Ulm 75005 Paris</s1><s3>FRA</s3><sZ>4 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Michels, Jean Jacques" sort="Michels, Jean Jacques" uniqKey="Michels J" first="Jean-Jacques" last="Michels">Jean-Jacques Michels</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Department of Pathology, Centre François Baclesse, Avenue Gen Harris 14000 Caen</s1><s3>FRA</s3><sZ>5 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Région Normandie</region><region type="old region" nuts="2">Basse-Normandie</region><settlement type="city">Caen</settlement></placeName></affiliation></author><author><name sortKey="Trassard, Martine" sort="Trassard, Martine" uniqKey="Trassard M" first="Martine" last="Trassard">Martine Trassard</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Department of Pathology, Centre René Huguenin, 35 Rue Dailly 92210 Saint-Cloud</s1><s3>FRA</s3><sZ>6 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Saint-Cloud</settlement></placeName></affiliation></author><author><name sortKey="Terrier, Philippe" sort="Terrier, Philippe" uniqKey="Terrier P" first="Philippe" last="Terrier">Philippe Terrier</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Department of Pathology, Institut Gustave Roussy, 39 Rue Camille Desmoulins</s1><s2>94800 Villejuif</s2><s3>FRA</s3><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Villejuif</settlement></placeName></affiliation></author><author><name sortKey="Birtwisle Peyrottes, Isabelle" sort="Birtwisle Peyrottes, Isabelle" uniqKey="Birtwisle Peyrottes I" first="Isabelle" last="Birtwisle-Peyrottes">Isabelle Birtwisle-Peyrottes</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Department of Pathology, Centre Antoine Lacassagne, 33, avenue de Valombrose 06189 Nice</s1><s3>FRA</s3><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Provence-Alpes-Côte d'Azur</region><settlement type="city">Nice</settlement></placeName></affiliation></author><author><name sortKey="Valo, Isabelle" sort="Valo, Isabelle" uniqKey="Valo I" first="Isabelle" last="Valo">Isabelle Valo</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Department of Pathology, Centre Paul Papin, 5 Rue Moll</s1><s2>49000 Angers</s2><s3>FRA</s3><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Pays de la Loire</region><settlement type="city">Angers</settlement></placeName></affiliation></author><author><name sortKey="Collin, Francoise" sort="Collin, Francoise" uniqKey="Collin F" first="Françoise" last="Collin">Françoise Collin</name><affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Department of Pathology, Centre George-François Leclerc, 1 r Prof Marion</s1><s2>21000 Dijon</s2><s3>FRA</s3><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Bourgogne-Franche-Comté</region><region type="old region" nuts="2">Bourgogne</region><settlement type="city">Dijon</settlement></placeName></affiliation></author><author><name sortKey="Chateau, Marie Christine" sort="Chateau, Marie Christine" uniqKey="Chateau M" first="Marie-Christine" last="Chateau">Marie-Christine Chateau</name><affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Department of Pathology, Centre Val-d'Aurelle, 31 rue de la Croix Verte</s1><s2>34000 Montpellier</s2><s3>FRA</s3><sZ>11 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Occitanie (région administrative)</region><region type="old region" nuts="2">Languedoc-Roussillon</region><settlement type="city">Montpellier</settlement></placeName></affiliation></author><author><name sortKey="Robin, Yves Marie" sort="Robin, Yves Marie" uniqKey="Robin Y" first="Yves-Marie" last="Robin">Yves-Marie Robin</name><affiliation wicri:level="3"><inist:fA14 i1="11"><s1>Department of Pathology, Centre Oscar Lambret, 3 rue Combemale</s1><s2>59020 Lille</s2><s3>FRA</s3><sZ>12 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Hauts-de-France</region><region type="old region" nuts="2">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Coindre, Jean Michel" sort="Coindre, Jean Michel" uniqKey="Coindre J" first="Jean-Michel" last="Coindre">Jean-Michel Coindre</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Pathology, Institut Bergonie, 229 Cours Argonne</s1><s2>33000 Bordeaux</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Nouvelle-Aquitaine</region><region type="old region" nuts="2">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">13-0084494</idno><date when="2013">2013</date><idno type="stanalyst">PASCAL 13-0084494 INIST</idno><idno type="RBID">Pascal:13-0084494</idno><idno type="wicri:Area/PascalFrancis/Corpus">000040</idno><idno type="wicri:Area/PascalFrancis/Curation">000915</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000031</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000031</idno><idno type="wicri:doubleKey">0959-8049:2013:Lindet C:localised:angiosarcomas:the</idno><idno type="wicri:Area/Main/Merge">003C84</idno><idno type="wicri:Area/Main/Curation">003C74</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Localised angiosarcomas: The identification of prognostic factors and analysis of treatment impact. A retrospective analysis from the French Sarcoma Group (GSF/GETO)</title><author><name sortKey="Lindet, Clothilde" sort="Lindet, Clothilde" uniqKey="Lindet C" first="Clothilde" last="Lindet">Clothilde Lindet</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of General Oncology, Oscar Lambret Cancer Center, 3 Rue Combemale</s1><s2>59020 Lille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Hauts-de-France</region><region type="old region" nuts="2">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Neuville, Agnes" sort="Neuville, Agnes" uniqKey="Neuville A" first="Agnès" last="Neuville">Agnès Neuville</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Pathology, Institut Bergonie, 229 Cours Argonne</s1><s2>33000 Bordeaux</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Nouvelle-Aquitaine</region><region type="old region" nuts="2">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Penel, Nicolas" sort="Penel, Nicolas" uniqKey="Penel N" first="Nicolas" last="Penel">Nicolas Penel</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of General Oncology, Oscar Lambret Cancer Center, 3 Rue Combemale</s1><s2>59020 Lille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Hauts-de-France</region><region type="old region" nuts="2">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Lae, Marick" sort="Lae, Marick" uniqKey="Lae M" first="Marick" last="Lae">Marick Lae</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Department of Pathology, Institut Curie, 26 Rue d'Ulm 75005 Paris</s1><s3>FRA</s3><sZ>4 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Michels, Jean Jacques" sort="Michels, Jean Jacques" uniqKey="Michels J" first="Jean-Jacques" last="Michels">Jean-Jacques Michels</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Department of Pathology, Centre François Baclesse, Avenue Gen Harris 14000 Caen</s1><s3>FRA</s3><sZ>5 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Région Normandie</region><region type="old region" nuts="2">Basse-Normandie</region><settlement type="city">Caen</settlement></placeName></affiliation></author><author><name sortKey="Trassard, Martine" sort="Trassard, Martine" uniqKey="Trassard M" first="Martine" last="Trassard">Martine Trassard</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Department of Pathology, Centre René Huguenin, 35 Rue Dailly 92210 Saint-Cloud</s1><s3>FRA</s3><sZ>6 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Saint-Cloud</settlement></placeName></affiliation></author><author><name sortKey="Terrier, Philippe" sort="Terrier, Philippe" uniqKey="Terrier P" first="Philippe" last="Terrier">Philippe Terrier</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Department of Pathology, Institut Gustave Roussy, 39 Rue Camille Desmoulins</s1><s2>94800 Villejuif</s2><s3>FRA</s3><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Villejuif</settlement></placeName></affiliation></author><author><name sortKey="Birtwisle Peyrottes, Isabelle" sort="Birtwisle Peyrottes, Isabelle" uniqKey="Birtwisle Peyrottes I" first="Isabelle" last="Birtwisle-Peyrottes">Isabelle Birtwisle-Peyrottes</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Department of Pathology, Centre Antoine Lacassagne, 33, avenue de Valombrose 06189 Nice</s1><s3>FRA</s3><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Provence-Alpes-Côte d'Azur</region><settlement type="city">Nice</settlement></placeName></affiliation></author><author><name sortKey="Valo, Isabelle" sort="Valo, Isabelle" uniqKey="Valo I" first="Isabelle" last="Valo">Isabelle Valo</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Department of Pathology, Centre Paul Papin, 5 Rue Moll</s1><s2>49000 Angers</s2><s3>FRA</s3><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Pays de la Loire</region><settlement type="city">Angers</settlement></placeName></affiliation></author><author><name sortKey="Collin, Francoise" sort="Collin, Francoise" uniqKey="Collin F" first="Françoise" last="Collin">Françoise Collin</name><affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Department of Pathology, Centre George-François Leclerc, 1 r Prof Marion</s1><s2>21000 Dijon</s2><s3>FRA</s3><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Bourgogne-Franche-Comté</region><region type="old region" nuts="2">Bourgogne</region><settlement type="city">Dijon</settlement></placeName></affiliation></author><author><name sortKey="Chateau, Marie Christine" sort="Chateau, Marie Christine" uniqKey="Chateau M" first="Marie-Christine" last="Chateau">Marie-Christine Chateau</name><affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Department of Pathology, Centre Val-d'Aurelle, 31 rue de la Croix Verte</s1><s2>34000 Montpellier</s2><s3>FRA</s3><sZ>11 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Occitanie (région administrative)</region><region type="old region" nuts="2">Languedoc-Roussillon</region><settlement type="city">Montpellier</settlement></placeName></affiliation></author><author><name sortKey="Robin, Yves Marie" sort="Robin, Yves Marie" uniqKey="Robin Y" first="Yves-Marie" last="Robin">Yves-Marie Robin</name><affiliation wicri:level="3"><inist:fA14 i1="11"><s1>Department of Pathology, Centre Oscar Lambret, 3 rue Combemale</s1><s2>59020 Lille</s2><s3>FRA</s3><sZ>12 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Hauts-de-France</region><region type="old region" nuts="2">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Coindre, Jean Michel" sort="Coindre, Jean Michel" uniqKey="Coindre J" first="Jean-Michel" last="Coindre">Jean-Michel Coindre</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Pathology, Institut Bergonie, 229 Cours Argonne</s1><s2>33000 Bordeaux</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Nouvelle-Aquitaine</region><region type="old region" nuts="2">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author></analytic><series><title level="j" type="main">European journal of cancer : (1990)</title><title level="j" type="abbreviated">Eur. j. cancer : (1990)</title><idno type="ISSN">0959-8049</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">European journal of cancer : (1990)</title><title level="j" type="abbreviated">Eur. j. cancer : (1990)</title><idno type="ISSN">0959-8049</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Age</term><term>Angiosarcoma</term><term>Cancerology</term><term>Lymphedema</term><term>Prognosis</term><term>Retrospective</term><term>Sarcoma</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Angiosarcome</term><term>Pronostic</term><term>Traitement</term><term>Sarcome</term><term>Rétrospective</term><term>Age</term><term>Lymphoedème</term><term>Cancérologie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Angiosarcomas represent less than 2% of all adult soft tissue sarcomas. Prognostic factors and the role of (neo-) adjuvant treatments in the management of localised angiosarcomas require further investigation. Methods: We have conducted a retrospective multicenter study (June 1980 to October 2009) of 107 patients with localised angiosarcomas. All of the cases were centrally reviewed by a certified pathologist. Univariate and multivariate analyses were conducted to identify independent poor prognostic factors (PF). Overall survival (OS) and Local Recurrence-Free Survival (LRFS) were estimated using the Kaplan-Meier method. The effect of treatments was explored using the Cox model after adjusting for the PF. Results: The median age was 71 years. 22.4% and 62.6% developed an angiosarcoma in pre-existing lymphoedema and within irradiated tissue respectively. The median OS, LRFS and Disease Recurrence-Free Survival (DRFS) were 38.8, 27 and 36.1 months, respectively. In multivariate analysis, the following parameters influenced the OS: lymphoedema (Hazard ratio (HR) = 2.0) and size >5 cm (HR = 1.5). After adjustment to these PF, RO margins was the only treatment parameter that improving the OS (HR = 0.2). In the multivariate analysis, the LRFS was influenced by an age >70 (HR = 1.8) and pre-existing lymphoedema (HR = 2.0). After adjustment for these PF, RO margins (HR = 0.5) and adjuvant radiotherapy (HR = 0.3) improved the LRFS. Conclusions: Our results suggest the following points: (i) pre-existing lymphoedema, tumour size and age >70 are probably the major prognostic factors in patients with localised angiosarcomas ; (ii) the achievement of RO margins is probably of major importance for improving the patient outcome and (iii) adjuvant radiotherapy probably decreased the risk of local recurrence.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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