Long-term outcomes in patients with radiation-associated angiosarcomas of the breast following surgery and radiotherapy for breast cancer
Identifieur interne : 004186 ( Main/Exploration ); précédent : 004185; suivant : 004187Long-term outcomes in patients with radiation-associated angiosarcomas of the breast following surgery and radiotherapy for breast cancer
Auteurs : Keila E. Torres [États-Unis] ; Vinod Ravi [États-Unis] ; Katherine Kin [États-Unis] ; Min Yi [États-Unis] ; B. Ashleigh Guadagnolo [États-Unis] ; Caitlin D. May [États-Unis] ; Banu K. Arun [États-Unis] ; Kelly K. Hunt [États-Unis] ; Ryan Lam [États-Unis] ; Guy Lahat [États-Unis] ; Aviad Hoffman [États-Unis] ; Janice N. Cormier [États-Unis] ; Barry W. Feig [États-Unis] ; Alexander J. Lazar [États-Unis] ; Dina Lev [États-Unis] ; Raphael E. Pollock [États-Unis]Source :
- Annals of surgical oncology [ 1068-9265 ] ; 2012.
Abstract
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).
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.
The median follow-up for all RAAS patients was 10.3 years (range, 2.4 – 31.8 years). The latency period following radiation exposure ranged from 1.4 to 26 years (median = 7 years). One- and five-year DSS rates were 93.5% and 62.6%, respectively. Reduced risk of local recurrence was observed in patients who received chemotherapy (
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.
Url:
DOI: 10.1245/s10434-012-2755-y
PubMed: 23224828
PubMed Central: 5036516
Affiliations:
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Torres</name><affiliation wicri:level="2"><nlm:aff id="A1">Dept. of Surgical Oncology, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Dept. of Surgical Oncology, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A2">Sarcoma Research Center, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Sarcoma Research Center, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Ravi, Vinod" sort="Ravi, Vinod" uniqKey="Ravi V" first="Vinod" last="Ravi">Vinod Ravi</name><affiliation wicri:level="2"><nlm:aff id="A3">Dept. of Sarcoma Medical Oncology, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Dept. of Sarcoma Medical Oncology, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Kin, Katherine" sort="Kin, Katherine" uniqKey="Kin K" first="Katherine" last="Kin">Katherine Kin</name><affiliation wicri:level="2"><nlm:aff id="A2">Sarcoma Research Center, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Sarcoma Research Center, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Yi, Min" sort="Yi, Min" uniqKey="Yi M" first="Min" last="Yi">Min Yi</name><affiliation wicri:level="2"><nlm:aff id="A1">Dept. of Surgical Oncology, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Dept. of Surgical Oncology, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Guadagnolo, B Ashleigh" sort="Guadagnolo, B Ashleigh" uniqKey="Guadagnolo B" first="B. 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Arun</name><affiliation wicri:level="2"><nlm:aff id="A5">Dept. of Breast Medical Oncology, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Dept. of Breast Medical Oncology, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Hunt, Kelly K" sort="Hunt, Kelly K" uniqKey="Hunt K" first="Kelly K." last="Hunt">Kelly K. 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Torres</name><affiliation wicri:level="2"><nlm:aff id="A1">Dept. of Surgical Oncology, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Dept. of Surgical Oncology, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A2">Sarcoma Research Center, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Sarcoma Research Center, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Ravi, Vinod" sort="Ravi, Vinod" uniqKey="Ravi V" first="Vinod" last="Ravi">Vinod Ravi</name><affiliation wicri:level="2"><nlm:aff id="A3">Dept. of Sarcoma Medical Oncology, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Dept. of Sarcoma Medical Oncology, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Kin, Katherine" sort="Kin, Katherine" uniqKey="Kin K" first="Katherine" last="Kin">Katherine Kin</name><affiliation wicri:level="2"><nlm:aff id="A2">Sarcoma Research Center, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Sarcoma Research Center, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Yi, Min" sort="Yi, Min" uniqKey="Yi M" first="Min" last="Yi">Min Yi</name><affiliation wicri:level="2"><nlm:aff id="A1">Dept. of Surgical Oncology, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Dept. of Surgical Oncology, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Guadagnolo, B Ashleigh" sort="Guadagnolo, B Ashleigh" uniqKey="Guadagnolo B" first="B. Ashleigh" last="Guadagnolo">B. Ashleigh Guadagnolo</name><affiliation wicri:level="2"><nlm:aff id="A4">Dept. of Radiation Oncology, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Dept. of Radiation Oncology, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="May, Caitlin D" sort="May, Caitlin D" uniqKey="May C" first="Caitlin D." last="May">Caitlin D. May</name><affiliation wicri:level="2"><nlm:aff id="A2">Sarcoma Research Center, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Sarcoma Research Center, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Arun, Banu K" sort="Arun, Banu K" uniqKey="Arun B" first="Banu K." last="Arun">Banu K. Arun</name><affiliation wicri:level="2"><nlm:aff id="A5">Dept. of Breast Medical Oncology, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Dept. of Breast Medical Oncology, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Hunt, Kelly K" sort="Hunt, Kelly K" uniqKey="Hunt K" first="Kelly K." last="Hunt">Kelly K. Hunt</name><affiliation wicri:level="2"><nlm:aff id="A1">Dept. of Surgical Oncology, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Dept. of Surgical Oncology, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Lam, Ryan" sort="Lam, Ryan" uniqKey="Lam R" first="Ryan" last="Lam">Ryan Lam</name><affiliation wicri:level="2"><nlm:aff id="A2">Sarcoma Research Center, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Sarcoma Research Center, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Lahat, Guy" sort="Lahat, Guy" uniqKey="Lahat G" first="Guy" last="Lahat">Guy Lahat</name><affiliation wicri:level="2"><nlm:aff id="A2">Sarcoma Research Center, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Sarcoma Research Center, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Hoffman, Aviad" sort="Hoffman, Aviad" uniqKey="Hoffman A" first="Aviad" last="Hoffman">Aviad Hoffman</name><affiliation wicri:level="2"><nlm:aff id="A2">Sarcoma Research Center, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Sarcoma Research Center, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Cormier, Janice N" sort="Cormier, Janice N" uniqKey="Cormier J" first="Janice N." last="Cormier">Janice N. Cormier</name><affiliation wicri:level="2"><nlm:aff id="A1">Dept. of Surgical Oncology, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Dept. of Surgical Oncology, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Feig, Barry W" sort="Feig, Barry W" uniqKey="Feig B" first="Barry W." last="Feig">Barry W. Feig</name><affiliation wicri:level="2"><nlm:aff id="A1">Dept. of Surgical Oncology, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Dept. of Surgical Oncology, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Lazar, Alexander J" sort="Lazar, Alexander J" uniqKey="Lazar A" first="Alexander J." last="Lazar">Alexander J. Lazar</name><affiliation wicri:level="2"><nlm:aff id="A2">Sarcoma Research Center, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Sarcoma Research Center, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A6">Dept. of Pathology, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Dept. of Pathology, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Lev, Dina" sort="Lev, Dina" uniqKey="Lev D" first="Dina" last="Lev">Dina Lev</name><affiliation wicri:level="2"><nlm:aff id="A2">Sarcoma Research Center, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Sarcoma Research Center, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A7">Dept. of Cancer Biology, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Dept. of Cancer Biology, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Pollock, Raphael E" sort="Pollock, Raphael E" uniqKey="Pollock R" first="Raphael E." last="Pollock">Raphael E. Pollock</name><affiliation wicri:level="2"><nlm:aff id="A1">Dept. of Surgical Oncology, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Dept. of Surgical Oncology, UT MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A2">Sarcoma Research Center, UT MD Anderson Cancer Center, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Sarcoma Research Center, UT MD Anderson Cancer Center, Houston</wicri:cityArea></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 id="S1"><title>Background</title><p id="P1">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).</p></sec><sec id="S2"><title>Methods</title><p id="P2">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.</p></sec><sec id="S3"><title>Results</title><p id="P3">The median follow-up for all RAAS patients was 10.3 years (range, 2.4 – 31.8 years). The latency period following radiation exposure ranged from 1.4 to 26 years (median = 7 years). One- and five-year DSS rates were 93.5% and 62.6%, respectively. Reduced risk of local recurrence was observed in patients who received chemotherapy (<italic>P</italic> = 0.0003). In multivariable analysis, size was found to be an independent predictor of adverse outcome (<italic>P</italic> = 0.015).</p></sec><sec id="S4"><title>Discussion</title><p id="P4">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.</p></sec></div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Texas</li></region></list><tree><country name="États-Unis"><region name="Texas"><name sortKey="Torres, Keila E" sort="Torres, Keila E" uniqKey="Torres K" first="Keila E." last="Torres">Keila E. Torres</name></region><name sortKey="Arun, Banu K" sort="Arun, Banu K" uniqKey="Arun B" first="Banu K." last="Arun">Banu K. Arun</name><name sortKey="Cormier, Janice N" sort="Cormier, Janice N" uniqKey="Cormier J" first="Janice N." last="Cormier">Janice N. Cormier</name><name sortKey="Feig, Barry W" sort="Feig, Barry W" uniqKey="Feig B" first="Barry W." last="Feig">Barry W. Feig</name><name sortKey="Guadagnolo, B Ashleigh" sort="Guadagnolo, B Ashleigh" uniqKey="Guadagnolo B" first="B. Ashleigh" last="Guadagnolo">B. Ashleigh Guadagnolo</name><name sortKey="Hoffman, Aviad" sort="Hoffman, Aviad" uniqKey="Hoffman A" first="Aviad" last="Hoffman">Aviad Hoffman</name><name sortKey="Hunt, Kelly K" sort="Hunt, Kelly K" uniqKey="Hunt K" first="Kelly K." last="Hunt">Kelly K. Hunt</name><name sortKey="Kin, Katherine" sort="Kin, Katherine" uniqKey="Kin K" first="Katherine" last="Kin">Katherine Kin</name><name sortKey="Lahat, Guy" sort="Lahat, Guy" uniqKey="Lahat G" first="Guy" last="Lahat">Guy Lahat</name><name sortKey="Lam, Ryan" sort="Lam, Ryan" uniqKey="Lam R" first="Ryan" last="Lam">Ryan Lam</name><name sortKey="Lazar, Alexander J" sort="Lazar, Alexander J" uniqKey="Lazar A" first="Alexander J." last="Lazar">Alexander J. Lazar</name><name sortKey="Lazar, Alexander J" sort="Lazar, Alexander J" uniqKey="Lazar A" first="Alexander J." last="Lazar">Alexander J. Lazar</name><name sortKey="Lev, Dina" sort="Lev, Dina" uniqKey="Lev D" first="Dina" last="Lev">Dina Lev</name><name sortKey="Lev, Dina" sort="Lev, Dina" uniqKey="Lev D" first="Dina" last="Lev">Dina Lev</name><name sortKey="May, Caitlin D" sort="May, Caitlin D" uniqKey="May C" first="Caitlin D." last="May">Caitlin D. May</name><name sortKey="Pollock, Raphael E" sort="Pollock, Raphael E" uniqKey="Pollock R" first="Raphael E." last="Pollock">Raphael E. Pollock</name><name sortKey="Pollock, Raphael E" sort="Pollock, Raphael E" uniqKey="Pollock R" first="Raphael E." last="Pollock">Raphael E. Pollock</name><name sortKey="Ravi, Vinod" sort="Ravi, Vinod" uniqKey="Ravi V" first="Vinod" last="Ravi">Vinod Ravi</name><name sortKey="Torres, Keila E" sort="Torres, Keila E" uniqKey="Torres K" first="Keila E." last="Torres">Keila E. Torres</name><name sortKey="Yi, Min" sort="Yi, Min" uniqKey="Yi M" first="Min" last="Yi">Min Yi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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