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Updated: Oct 15, 2025

A Mouse Model of Incompletely Resected Soft Tissue Sarcoma for Testing Neoadjuvant Therapies
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Neoadjuvant radiation for cutaneous and soft tissue angiosarcoma.

Cimarron E Sharon1, Richard J Straker1, Adrienne B Shannon1

  • 1Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Journal of Surgical Oncology
|October 24, 2021
PubMed
Summary

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Neoadjuvant radiation (NRT) improves complete tumor resection rates in angiosarcoma. However, NRT is rarely used, especially for large or head/neck tumors where it may be most beneficial.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Radiation Oncology

Background:

  • Neoadjuvant radiation (NRT) is a standard treatment for soft tissue sarcomas, aiming to improve local control.
  • The effectiveness and utilization of NRT in cutaneous and soft tissue angiosarcoma are not well-established.

Purpose of the Study:

  • To evaluate the utilization and impact of NRT on resection margins and survival in patients with angiosarcoma.
  • To identify factors associated with NRT receipt and margin positivity in angiosarcoma patients.

Main Methods:

  • Retrospective cohort study using the National Cancer Database (2004-2016).
  • Inclusion of patients with clinically localized, surgically resected angiosarcomas.
  • Analysis of factors associated with NRT receipt and margin positivity using logistic regression; survival assessed with Kaplan-Meier analysis.
Keywords:
angiosarcomaneoadjuvant therapyradiationsurgical margins

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Main Results:

  • Only 4.5% of 597 angiosarcoma patients received NRT.
  • NRT was associated with increased rates of R0 resection (100% vs. 17.9% without NRT).
  • Tumor size (≥5 cm) and head/neck location were associated with margin positivity; NRT did not significantly improve survival.

Conclusions:

  • Neoadjuvant radiation therapy significantly improves R0 resection rates in angiosarcoma.
  • NRT is underutilized in angiosarcoma, particularly for tumors ≥5 cm or in the head/neck region.
  • Increased NRT use in specific angiosarcoma cases may enhance complete surgical resection outcomes.