Analysis of risk factors affecting the prognosis of angiosarcoma patients: a retrospective study

This study aimed to identify prognostic factors influencing the survival of angiosarcoma patients and to explore the relationship between peripheral blood indicators and patient prognosis. A retrospective analysis was conducted on the clinical data collected from 105 angiosarcoma patients treated at China-Japan Union Hospital of Jilin University from January 2004 to April 2019, with an additional 50 patients included as external validation cohort. The median survival time for the study cohort was 1395 days, with 66.7% of patients (n=70) dying during the follow-up period. Significant differences were observed between the survival and death groups in age (P=0.022), primary tumor site (P=0.013), tumor size (P=0.008), and metastasis (P=0.018). Analysis of peripheral blood indicators showed that white blood cell (WBC) (P=0.006), platelet (PLT) (P=0.019), platelet-to-lymphocyte ratio (PLR) (P<0.001), and systemic immune-inflammation index (SII) (P=0.036) were significantly lower in the survival group, while lymphocyte (LYM) (P<0.001), albumin (ALB) (P<0.001), and prognostic nutritional index (PIN) (P<0.001) were significantly higher in the survival group. Multivariate Cox regression analysis identified SII (P=0.049, HR=0.551, 95% CI: 0.304-0.998), primary tumor site (P=0.001, HR=0.405, 95% CI: 0.235-0.699), metastasis (P=0.029, HR=1.864, 95% CI: 1.066-3.26), and chemotherapy (P=0.004, HR=0.434, 95% CI: 0.245-0.768) as independent prognostic factors affecting patients' 5-year survival. A nomogram model constructed based on these factors demonstrated high accuracy and stability in predicting 1-year, 3-year, and 5-year survival rates, with area under the curve (AUC) values of 0.836, 0.837, and 0.803, respectively, as validated by calibration curves and receiver operating characteristic (ROC) analysis. External validation further confirmed the model's reliability. Additionally, significant interactions were found between SII and primary tumor site (P=0.005) as well as chemotherapy (P=0.045). In conclusion, SII, primary tumor site, metastasis, and chemotherapy are crucial prognostic factors for angiosarcoma, and the developed nomogram provides a reliable tool for predicting survival outcomes.