Key result
Tumor resection and radiation therapy were independent predictors of better survival in patients with primary pleural angiosarcoma, with hazard ratios of 0.3 and 0.1, respectively.
Why the study?
Primary pleural angiosarcoma is an extremely rare, rapidly fatal malignancy with no treatment consensus, leaving its clinical spectrum poorly defined.
Do tumor resection, radiation therapy, or chemotherapy improve overall survival in patients with primary pleural angiosarcoma?
Observational (n=43)
Do tumor resection, radiation therapy, or chemotherapy improve overall survival in patients with primary pleural angiosarcoma?
In patients with primary pleural angiosarcoma, tumor resection and radiation therapy may offer a survival benefit, whereas the presence of hemothorax is associated with a poorer prognosis.
Answers are grounded in this paper and cite their sources.
May support resection/radiation in select pleural angiosarcoma cases; leaves open optimal therapy pending prospective validation.
Primary pleural angiosarcoma (PPA) is an extremely rare malignancy for which there is no consensus on treatment. The clinical course of PPA is usually quickly fatal, regardless of the treatment used.We summarized and evaluated a relatively large population of published PPA cases to assess prognostic factors, diagnostic approaches, treatment methods and clinical outcomes. Using the CNKI, Embase, and PubMed databases, literature published in English and Chinese from 1988 through 2020 was searched using the terms "primary pleural angiosarcoma," "pleural angiosarcoma," and "pleuropulmonary angiosarcoma."A total of 43 patients with PPA were identified in retrospective case series and case reports. The median age at diagnosis was 64 years (range 24-87 years), and the median overall survival was 4 months (range 0.1-180 months). Approximately 80% of patients died from PPA within 10 months of diagnosis, and the 2-year survival rate was approximately 4.4%. In univariate analyses, the presence of pleural effusion and hemothorax were significant predictors of decreased survival, with hazard ratios (HRs) of 2.7 (P = .04) and 3.3 (P = .006), respectively. Sixteen patients received no therapy, and their prognosis was worse than patients who did receive therapy (P = .019). Radiation therapy improved survival more than no radiation therapy (P = .007). Patients appeared to derive clinical benefit from chemotherapy (P = .048). However, tumor resection did not seem to provide a survival benefit (P = .051). In multivariate analysis, tumor resection, and radiation were independent, statistically significant, positive predictors of better survival, with HRs of 0.3 (P = .017) and 0.1 (P = .006), respectively. The presence of hemothorax was an independent predictor of worse prognosis (P = .006).Primary angiosarcoma of the pleura is a rare, poorly understood malignancy with a poor prognosis; hence, the clinical spectrum of PPA is not completely defined. By multivariate analysis, this retrospective study showed a survival benefit of tumor resection or radiation therapy, and the presence of hemothorax was a significant prognostic factor for poor outcomes.
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A 2022 study conducted an observational in Primary pleural angiosarcoma (n=43). Tumor resection vs. No tumor resection was evaluated on Overall survival (HR 0.3, 95% CI 0.12-0.81, p=0.017). Tumor resection and radiation therapy were independent predictors of better survival in patients with primary pleural angiosarcoma, with hazard ratios of 0.3 and 0.1, respectively.
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