Localized angiosarcomas (AS): Identification of prognostic factors (PF) and analysis of treatment impact—Series from the French Sarcoma Group (GSF/GETO).

10018 Background: AS represents less than 2% of all adult soft tissue sarcoma. PF and role of respective (neo)-adjuvant treatments in management of localized AS remain badly established. Methods: We have conducted a retrospective multicentre study (June 1980-October 2009) of 107 patients with localized AS. All cases have been centrally reviewed by pathologist expert. Univariate and multivariate analysis were conducted to identify independent PF. Overall survival (OS) and Local Recurrence Free Survival (LRFS) were estimated using the Kaplan-Meier method. Impact of treatments had been explored with Cox Model after adjustment to the PF. Results: The sex ratio was 18/89 (0.2). Median age was 71 years. 22% (24/107) and 62% (67/107) of patients developed AS in preexisting lymphoedema and in irradiated field, respectively. 71 cases (66%) were superficial. The most frequent primary locations were: limbs (35, 33%), chest wall (32, 29%) and breast (22, 20%). Grade was 1 in 21/103 (20%), 2 in 35/103 (34%) and 3 in 47/103 cases (46%). Treatments consisted in surgery, adjuvant radiotherapy and (neo)-adjuvant chemotherapy in, respectively, 95, 27 and 27 cases. R0 margin was obtained in 49 cases. The median OS and LRFS were, respectively, 38.8 months and 27 months. In multivariate analysis, the following PF influenced the OS: lymphedema (HR=2.02 [1.15-3.55]) and size>5 cm (HR=1.48 [1.01-2.45]). After adjustment to these PF, R0 margins was the sole treatment parameter improving the OS (HR=0.19 [0.05-0.73]). In multivariate analysis, the following PF influence the LRFS: Age>70 (HR=1.68 [1.02-2.76]) and pre-existing lymphedema (HR=2.07 [1.15-3.75]). After adjustment to these prognostic factors, R0 margins (HR=0.48 [0.38-0.69]) and adjuvant radiotherapy (HR=0.29 [0.10-0.83]) improved the LRFS. Conclusions: Pre-existing lymphedema, tumour size and age>70 are the major PF in patients with localized AS. The achievement of R0 margins is of major importance for improving the outcome whatever the endpoint (OS, LRFS) Adjuvant radiotherapy decreased the local recurrence. (Neo)-adjuvant chemotherapy does not influence survivals.