Abstract
e23563 Background: Angiosarcoma is a rare subtype of soft tissue sarcoma associated with a generally poor prognosis and high mortality rate. Median survival of patients with angiosarcoma typically ranges from 15 to 24 months, with a 5-year survival of 12-33%. Angiosarcomas have a high propensity for local recurrence, metastasis, and multiple organ involvement as they originate from vascular endothelial cells. Though surgical excision currently plays a central role in the treatment of angiosarcoma, no significant study has analyzed NCDB for treatment trends in these patients. This study aims to characterize the effect of different treatment modalities on overall survival of angiosarcoma patients. Methods: The National Cancer Database (NCDB) was used to identify patients diagnosed with angiosarcoma from 2004 to 2020 using histology code 9120 as assigned by the Commission on Cancer Accreditation program. Kaplan-Meier, ANOVA, Chi-Square, Cox Proportional Hazards and Logistic Regression tests were performed, and data were analyzed using SPSS version 29. Statistical significance was set at α = 0.05. Results: 3560 patients with angiosarcoma of the soft tissue were queried. The most common primary site for a tumor was the head, neck, or face (920 patients, 31.3%). Of the initial sample, 1889 ( 53.1%) patients received surgery alone, 450 ( 12.6%) patients received adjuvant chemotherapy, 55 ( 1.54%) received adjuvant radiation, and 30 ( 0.84%) patients received adjuvant chemoradiation. Surgery alone conferred the greatest median survival; no surgery conferred the least ( 31.4 months vs. 7.2 months; p < 0.001). In the crude and adjusted logistic regression models, combined chemoradiation (OR = .210; 95% CI:.100-.400) and surgery alone were associated with the lowest odds of death (OR = .271; 95% CI: .224-.329) relative to no surgical procedure of the primary site. This finding persisted once the model was adjusted for age, stage, and tumor size. Surgery alone conferred the lowest hazard ratio (HR = .352; 95% CI: .323-.384) relative to no surgery. Conclusions: In angiosarcoma patients, surgical excision at the primary site alone was associated with the greatest median survival and the lowest hazard ratio. Additionally, angiosarcoma patients who did not receive surgery had the least median survival. Surgery with adjuvant chemoradiation and surgery alone had the lowest odds of death. These findings affirm that surgical excision at the site of the primary tumor plays a key role in increasing the survival of angiosarcoma patients. Further research is necessary in characterizing treatment trends in angiosarcoma patients to supplement current standardized treatment protocols and improve the mortality of this lethal cancer.