Radiation-Associated Angiosarcoma After Breast Cancer: High Recurrence Rate and Poor Survival Despite Surgical Treatment with R0 Resection
Identifieur interne : 003F58 ( Main/Exploration ); précédent : 003F57; suivant : 003F59Radiation-Associated Angiosarcoma After Breast Cancer: High Recurrence Rate and Poor Survival Despite Surgical Treatment with R0 Resection
Auteurs : Jojanneke M. Seinen [Pays-Bas] ; Emelie Styring [Suède] ; Vincent Verstappen [Pays-Bas] ; Fredrik Vult Von Steyern [Suède] ; Anders Rydholm [Suède] ; Albert J. H. Suurmeijer [Pays-Bas] ; Harald J. Hoekstra [Pays-Bas]Source :
- Annals of Surgical Oncology [ 1068-9265 ] ; 2012.
Abstract
Secondary angiosarcoma of the breast is a rare but severe long-term complication of breast cancer treated with breast-conserving surgery and radiotherapy. We characterized a population-based cohort of patients with secondary angiosarcomas from two tertiary hospitals to investigate this complication with respect to surgical treatment and outcome.
We identified 35 patients with a history of radiation for breast cancer that developed angiosarcoma in the irradiated field from 1990 to 2009. Of these, 31 underwent surgery and were included for analysis.
Angiosarcoma developed after median 7 years (range 3–25 years). R0 resection was obtained in 23 of 31 patients after primary treatment. Local recurrence developed in 19 patients after median 6 months (range 1–89 months). Regional and distant metastases occurred in 13 patients after median 17 months (range 2–50 months); nine which also had local recurrence. Patients whose local recurrence could be operated on had a better survival after treatment than those who were not considered for surgical treatment, median 34 months (range 6–84 months) compared with 6 months (range 5–24 months). The median disease-free survival and disease-specific survival was 16 and 37 months, respectively.
Despite R0 resection, two-thirds of the patients developed a local recurrence. Survival among those with local recurrence was better if the patient could be treated with surgery. Overall, the prognosis was dismal and median DSS was just over 3 years.
Url:
DOI: 10.1245/s10434-012-2310-x
PubMed: 22466664
PubMed Central: 3404270
Affiliations:
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Seinen</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, University of Groningen University Medical Center, Groningen, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, University of Groningen University Medical Center, Groningen</wicri:regionArea><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation></author><author><name sortKey="Styring, Emelie" sort="Styring, Emelie" uniqKey="Styring E" first="Emelie" last="Styring">Emelie Styring</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Orthopedics, Lund University, Lund University Hospital, Lund, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Orthopedics, Lund University, Lund University Hospital, Lund</wicri:regionArea><wicri:noRegion>Lund</wicri:noRegion></affiliation></author><author><name sortKey="Verstappen, Vincent" sort="Verstappen, Vincent" uniqKey="Verstappen V" first="Vincent" last="Verstappen">Vincent Verstappen</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, University of Groningen University Medical Center, Groningen, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, University of Groningen University Medical Center, Groningen</wicri:regionArea><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation></author><author><name sortKey="Vult Von Steyern, Fredrik" sort="Vult Von Steyern, Fredrik" uniqKey="Vult Von Steyern F" first="Fredrik" last="Vult Von Steyern">Fredrik Vult Von Steyern</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Orthopedics, Lund University, Lund University Hospital, Lund, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Orthopedics, Lund University, Lund University Hospital, Lund</wicri:regionArea><wicri:noRegion>Lund</wicri:noRegion></affiliation></author><author><name sortKey="Rydholm, Anders" sort="Rydholm, Anders" uniqKey="Rydholm A" first="Anders" last="Rydholm">Anders Rydholm</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Orthopedics, Lund University, Lund University Hospital, Lund, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Orthopedics, Lund University, Lund University Hospital, Lund</wicri:regionArea><wicri:noRegion>Lund</wicri:noRegion></affiliation></author><author><name sortKey="Suurmeijer, Albert J H" sort="Suurmeijer, Albert J H" uniqKey="Suurmeijer A" first="Albert J. 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Seinen</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, University of Groningen University Medical Center, Groningen, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, University of Groningen University Medical Center, Groningen</wicri:regionArea><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation></author><author><name sortKey="Styring, Emelie" sort="Styring, Emelie" uniqKey="Styring E" first="Emelie" last="Styring">Emelie Styring</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Orthopedics, Lund University, Lund University Hospital, Lund, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Orthopedics, Lund University, Lund University Hospital, Lund</wicri:regionArea><wicri:noRegion>Lund</wicri:noRegion></affiliation></author><author><name sortKey="Verstappen, Vincent" sort="Verstappen, Vincent" uniqKey="Verstappen V" first="Vincent" last="Verstappen">Vincent Verstappen</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, University of Groningen University Medical Center, Groningen, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, University of Groningen University Medical Center, Groningen</wicri:regionArea><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation></author><author><name sortKey="Vult Von Steyern, Fredrik" sort="Vult Von Steyern, Fredrik" uniqKey="Vult Von Steyern F" first="Fredrik" last="Vult Von Steyern">Fredrik Vult Von Steyern</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Orthopedics, Lund University, Lund University Hospital, Lund, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Orthopedics, Lund University, Lund University Hospital, Lund</wicri:regionArea><wicri:noRegion>Lund</wicri:noRegion></affiliation></author><author><name sortKey="Rydholm, Anders" sort="Rydholm, Anders" uniqKey="Rydholm A" first="Anders" last="Rydholm">Anders Rydholm</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Orthopedics, Lund University, Lund University Hospital, Lund, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Orthopedics, Lund University, Lund University Hospital, Lund</wicri:regionArea><wicri:noRegion>Lund</wicri:noRegion></affiliation></author><author><name sortKey="Suurmeijer, Albert J H" sort="Suurmeijer, Albert J H" uniqKey="Suurmeijer A" first="Albert J. H." last="Suurmeijer">Albert J. H. Suurmeijer</name><affiliation wicri:level="3"><nlm:aff id="Aff2">Department of Pathology, University of Groningen University Medical Center, Groningen, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Pathology, University of Groningen University Medical Center, Groningen</wicri:regionArea><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation></author><author><name sortKey="Hoekstra, Harald J" sort="Hoekstra, Harald J" uniqKey="Hoekstra H" first="Harald J." last="Hoekstra">Harald J. Hoekstra</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, University of Groningen University Medical Center, Groningen, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, University of Groningen University Medical Center, Groningen</wicri:regionArea><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation></author></analytic><series><title level="j">Annals of Surgical Oncology</title><idno type="ISSN">1068-9265</idno><idno type="eISSN">1534-4681</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Secondary angiosarcoma of the breast is a rare but severe long-term complication of breast cancer treated with breast-conserving surgery and radiotherapy. We characterized a population-based cohort of patients with secondary angiosarcomas from two tertiary hospitals to investigate this complication with respect to surgical treatment and outcome.</p></sec><sec><title>Methods</title><p>We identified 35 patients with a history of radiation for breast cancer that developed angiosarcoma in the irradiated field from 1990 to 2009. Of these, 31 underwent surgery and were included for analysis.</p></sec><sec><title>Results</title><p>Angiosarcoma developed after median 7 years (range 3–25 years). R0 resection was obtained in 23 of 31 patients after primary treatment. Local recurrence developed in 19 patients after median 6 months (range 1–89 months). Regional and distant metastases occurred in 13 patients after median 17 months (range 2–50 months); nine which also had local recurrence. Patients whose local recurrence could be operated on had a better survival after treatment than those who were not considered for surgical treatment, median 34 months (range 6–84 months) compared with 6 months (range 5–24 months). The median disease-free survival and disease-specific survival was 16 and 37 months, respectively.</p></sec><sec><title>Conclusions</title><p>Despite R0 resection, two-thirds of the patients developed a local recurrence. Survival among those with local recurrence was better if the patient could be treated with surgery. 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Araujo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sm, Bentzen" uniqKey="Sm B">Bentzen SM</name></author><author><name sortKey="Agrawal, Rk" uniqKey="Agrawal R">RK Agrawal</name></author><author><name sortKey="Aird, Eg" uniqKey="Aird E">EG Aird</name></author><author><name sortKey="Barrett, Jm" uniqKey="Barrett J">JM Barrett</name></author><author><name sortKey="Barrett Lee, Pj" uniqKey="Barrett Lee P">PJ Barrett-Lee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sm, Bentzen" uniqKey="Sm B">Bentzen SM</name></author><author><name sortKey="Agrawal, Rk" uniqKey="Agrawal R">RK Agrawal</name></author><author><name sortKey="Aird, Eg" uniqKey="Aird E">EG Aird</name></author><author><name sortKey="Barrett, Jm" uniqKey="Barrett J">JM Barrett</name></author><author><name sortKey="Barrett Lee, Pj" uniqKey="Barrett Lee P">PJ Barrett-Lee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Whelan, Tj" uniqKey="Whelan T">TJ Whelan</name></author><author><name sortKey="Pignol, Jp" uniqKey="Pignol J">JP Pignol</name></author><author><name sortKey="Levine, Mn" uniqKey="Levine M">MN Levine</name></author><author><name sortKey="Julian, Ja" uniqKey="Julian J">JA Julian</name></author><author><name sortKey="Mackenzie, R" uniqKey="Mackenzie R">R MacKenzie</name></author><author><name sortKey="Parpia, S" uniqKey="Parpia S">S Parpia</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bartelink, H" uniqKey="Bartelink H">H Bartelink</name></author><author><name sortKey="Horiot, Jc" uniqKey="Horiot J">JC Horiot</name></author><author><name sortKey="Poortmans, Pm" uniqKey="Poortmans P">PM Poortmans</name></author><author><name sortKey="Struikmans, H" uniqKey="Struikmans H">H Struikmans</name></author><author><name sortKey="Bogaert, W" uniqKey="Bogaert W">W Bogaert</name></author><author><name sortKey="Fourquet, A" uniqKey="Fourquet A">A Fourquet</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Smith, Te" uniqKey="Smith T">TE Smith</name></author><author><name sortKey="Lee, D" uniqKey="Lee D">D Lee</name></author><author><name sortKey="Turner, Bc" uniqKey="Turner B">BC Turner</name></author><author><name sortKey="Carter, D" uniqKey="Carter D">D Carter</name></author><author><name sortKey="Haffty, Bg" uniqKey="Haffty B">BG Haffty</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vicini, F" uniqKey="Vicini F">F Vicini</name></author><author><name sortKey="Winter, K" uniqKey="Winter K">K Winter</name></author><author><name sortKey="Straube, W" uniqKey="Straube W">W Straube</name></author><author><name sortKey="Wong, J" uniqKey="Wong J">J Wong</name></author><author><name sortKey="Pass, H" uniqKey="Pass H">H Pass</name></author><author><name sortKey="Rabinovitch, R" uniqKey="Rabinovitch R">R Rabinovitch</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vicini, F" uniqKey="Vicini F">F Vicini</name></author><author><name sortKey="Winter, K" uniqKey="Winter K">K Winter</name></author><author><name sortKey="Wong, J" uniqKey="Wong J">J Wong</name></author><author><name sortKey="Pass, H" uniqKey="Pass H">H Pass</name></author><author><name sortKey="Rabinovitch, R" uniqKey="Rabinovitch R">R Rabinovitch</name></author><author><name sortKey="Chafe, S" uniqKey="Chafe S">S Chafe</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Pays-Bas</li><li>Suède</li></country><region><li>Groningue (province)</li></region><settlement><li>Groningue</li></settlement></list><tree><country name="Pays-Bas"><region name="Groningue (province)"><name sortKey="Seinen, Jojanneke M" sort="Seinen, Jojanneke M" uniqKey="Seinen J" first="Jojanneke M." last="Seinen">Jojanneke M. Seinen</name></region><name sortKey="Hoekstra, Harald J" sort="Hoekstra, Harald J" uniqKey="Hoekstra H" first="Harald J." last="Hoekstra">Harald J. Hoekstra</name><name sortKey="Suurmeijer, Albert J H" sort="Suurmeijer, Albert J H" uniqKey="Suurmeijer A" first="Albert J. H." last="Suurmeijer">Albert J. H. Suurmeijer</name><name sortKey="Verstappen, Vincent" sort="Verstappen, Vincent" uniqKey="Verstappen V" first="Vincent" last="Verstappen">Vincent Verstappen</name></country><country name="Suède"><noRegion><name sortKey="Styring, Emelie" sort="Styring, Emelie" uniqKey="Styring E" first="Emelie" last="Styring">Emelie Styring</name></noRegion><name sortKey="Rydholm, Anders" sort="Rydholm, Anders" uniqKey="Rydholm A" first="Anders" last="Rydholm">Anders Rydholm</name><name sortKey="Vult Von Steyern, Fredrik" sort="Vult Von Steyern, Fredrik" uniqKey="Vult Von Steyern F" first="Fredrik" last="Vult Von Steyern">Fredrik Vult Von Steyern</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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