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Primary Angiosarcoma of Bone: A Retrospective Analysis of 60 Patients From 2 Institutions

Palmerini, Emanuela MD*; Maki, Robert G. MD, PhD; Staals, Eric L. MD; Alberghini, Marco MD§; Antonescu, Cristina R. MD; Ferrari, Crisitina BSc; Ruggieri, Pietro MD, PhD; Mavrogenis, Andreas MD; Bertoni, Franco MD, PhD§; Cesari, Marilena MD*; Paioli, Anna MD*; Marchesi, Emanuela PhD*; Picci, Piero MD; Ferrari, Stefano MD*

American Journal of Clinical Oncology: December 2014 - Volume 37 - Issue 6 - p 528–534
doi: 10.1097/COC.0b013e31827defa1
Original Articles: Bone
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Background: Angiosarcoma of bone is a rare high-grade malignant vascular tumor. The literature regarding treatment and outcome of patients with this tumor is limited.

We performed a 2 institutional retrospective study to analyze treatment and survival of patients with angiosarcoma of bone.

Patients and Methods: We reviewed patients with the histologic diagnosis of primary angiosarcoma of bone treated from 1980 to 2009. Demographic details, histology, treatment, and survival were reviewed.

Results: A total of 38 men and 22 women (median age, 54 y) were recruited. Most lesions occurred in the femur and the pelvis. Metastatic disease at presentation was diagnosed in 24 patients (40%). Forty-three patients underwent surgery, with 30 of them achieving surgical complete remission (SCR). Radiotherapy was applied to 17 patients, and chemotherapy to 13/35 and 15/22 patients with localized and metastatic disease, respectively.

The 5-year overall survival (OS) was 20%: 33% for patients with localized disease and 0% for metastatic patients. Higher 5-year OS was reported for patients who achieved SCR (46%) than for those who did not (0%). In nonmetastatic patients, a trend toward improved survival was observed after SCR and adjuvant chemotherapy based on cisplatin, doxorubicin, and ifosfamide.

Fifteen patients received chemotherapy for metastases. Two RECIST partial responses of 13 evaluable patients were documented (paclitaxel [n=1] and doxorubicin [n=1]). Stable disease was observed in 2 patients.

Conclusions: Complete surgical resection is essential for outcome. Survival of patients with metastatic or unresectable disease is very poor. Activity of taxanes and anthracycline was observed in the metastatic setting and merits further evaluation.

Departments of *Chemotherapy

Orthopaedic Surgery

§Surgical Pathology

Research Laboratory, Musculoskeletal Oncology Department, Istituto Ortopedico Rizzoli, Bologna, Italy

Departments of Medicine

Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY

Present address: R.G. Maki, Departments of Medicine, Pediatrics, and Orthopaedics, Mount Sinai School of Medicine, New York, NY.

The authors declare no conflicts of interest.

Reprints: Emanuela Palmerini, MD, Department of Oncology, Istituto Ortopedico Rizzoli, 1 Via Pupilli, 40136 Bologna, Italy. E-mail: emanuela.palmerini@ior.it.

Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.