European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2025
Clinicopathological characteristics, long-term prognosis and follow-up recommendations of primary and secondary cutaneous angiosarcoma: A Danish nationwide population-based cohort study.
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Abebe Kiya, Wulff Ida, Thorsen Katrine Voss, Wagenblast Anne Lene, Schmidt Grethe, Jensen David Hebbelstrup, Holm Christina Enciso, Petersen Michael M, Loya Anand C, Mentzel Thomas, Herly Mikkel, Ørholt Mathias, Vester-Glowinski Peter
Аннотация
BACKGROUND: The prognostic impact of subclassifying tumors as primary and secondary cutaneous angiosarcoma (cAS) in terms of the risk of local recurrence, metastasis, disease-specific mortality, and overall survival has not been extensively investigated in previous studies. This study aimed to characterize the clinicopathological features and estimate the 2-, 5-, and 10-year rates of local recurrence, metastasis, disease-specific death, and overall survival for patients with primary and secondary cAS, and to propose a follow-up recommendation for these patients.
METHODS: All Danish patients diagnosed with cAS between 2000 and 2023 were included. The prognosis was estimated using age- and sex-standardized stratified cause-specific Cox-regression with all-cause mortality as a competing risk.
RESULTS: A total of 192 patients were included, comprising 99 patients with primary cAS and 93 with secondary cAS. The 5-year local recurrence rate was similar between primary (42 %) and secondary cAS (39 %). However, patients with primary cAS exhibited a higher 5-year rate of metastasis (50 %) compared to those with secondary cAS (33 %). Similarly, the 5-year disease-specific mortality was substantially higher in patients with primary cAS (57 %) compared to secondary cAS (35 %). Correspondingly, the 5-year overall survival rate was low in both primary (32 %) and secondary cAS (49 %).
CONCLUSION: Primary cAS is associated with poorer 5-year outcomes of metastasis, disease-specific death, and overall survival compared with secondary cAS. Follow-up could be limited to 5 years, as >95 % of the relapses occurred within this period and may include clinical examinations and local MRI to detect local recurrences, and cross-sectional imaging to detect regional and distant metastases.
METHODS: All Danish patients diagnosed with cAS between 2000 and 2023 were included. The prognosis was estimated using age- and sex-standardized stratified cause-specific Cox-regression with all-cause mortality as a competing risk.
RESULTS: A total of 192 patients were included, comprising 99 patients with primary cAS and 93 with secondary cAS. The 5-year local recurrence rate was similar between primary (42 %) and secondary cAS (39 %). However, patients with primary cAS exhibited a higher 5-year rate of metastasis (50 %) compared to those with secondary cAS (33 %). Similarly, the 5-year disease-specific mortality was substantially higher in patients with primary cAS (57 %) compared to secondary cAS (35 %). Correspondingly, the 5-year overall survival rate was low in both primary (32 %) and secondary cAS (49 %).
CONCLUSION: Primary cAS is associated with poorer 5-year outcomes of metastasis, disease-specific death, and overall survival compared with secondary cAS. Follow-up could be limited to 5 years, as >95 % of the relapses occurred within this period and may include clinical examinations and local MRI to detect local recurrences, and cross-sectional imaging to detect regional and distant metastases.