Cutaneous Angiosarcoma Secondary to Lymphoedema or Radiation Therapy - A Systematic Review

Area of Science:

• Oncology
• Medical Research
• Cancer Epidemiology

Background:

• Secondary angiosarcoma is a rare but aggressive cancer.
• It is frequently associated with pre-existing lymphoedema or prior radiation therapy, particularly after breast cancer treatment.
• Understanding its clinical features and outcomes is vital for improving patient management.

Purpose of the Study:

• To systematically review and evaluate the clinical features and outcomes of secondary angiosarcoma.
• To specifically analyze angiosarcomas arising after breast cancer treatment and those associated with lymphoedema.
• To identify key characteristics and prognostic factors for this rare cancer.

Main Methods:

• A systematic review was conducted following the PRISMA protocol.
• Searches were performed across major databases (Medline, EMBASE, CINAHL, Cochrane) for English articles up to April 2018.
• Data extraction and relevance screening were performed independently by two researchers.

Main Results:

• 72 secondary angiosarcomas of the limbs were identified, with 94.4% linked to lymphoedema and a median latency of 15 years.
• 83 breast angiosarcomas were analyzed, with 65.1% having a history of adjuvant radiotherapy and a median latency of 6 years.
• Mortality durations were notably shorter for limb angiosarcomas (median 10.5 months) compared to breast angiosarcomas (median 31 months).

Conclusions:

• Secondary angiosarcoma, particularly in lymphoedematous limbs or post-breast cancer irradiation, is uncommon but characterized by long latency and high mortality.
• The findings underscore the need for long-term, vigilant surveillance in at-risk patient populations.
• Further research into optimal treatment strategies and prognostic markers is warranted.