Radiation Oncology/Sarcoma/Sarcomas of the Aorta

Sarcomas of the Aorta

• U. Colorado/Moffitt PMID 24485779 -- "Sarcomas of the aorta: a systematic review and pooled analysis of published reports" (Rusthoven CG, Ann Vasc Surg. 2014 Feb;28(2):515-25)
  • Systematic review of 165 reported cases of primary aortic sarcomas
    • Median age 60, male to female ratio 1.5 to 1.
    • Median overall survival 11 months; 1-, 3-, 5-year rates of 47%, 17%, and 9%.
    • High grade sarcomas (87%), arterial embolization (47%), and metastatic disease at diagnosis (45%) common
    • Most common sites of embolization were abdomen (23%) and extremities (21%).
    • Most common sites of metastases were bone (29%) and lung (16%)
    • Reported histologies included undifferentiated (39%), angiosarcomatous (37%), leiomyosarcomatous (13%), and fibroblastic (7.3%) sarcomas
    • Univariate OS analysis: absence of metastases at diagnosis (p<.001), management with surgical resection (P<.001), and chemotherapy (p=.02) beneficial. Multivariate: only metastatic disease (P<.001) remained significant
  • Conclusion: Poor prognosis overall. Long term survivors have been reported with aggressive management involving resection + adjuvant therapy. High embolic rates suggest a potential role for prophylactic anticoagulation