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      Surgical Resection and Pazopanib Treatment for Recurrent Cardiac Angiosarcoma

      brief-report

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          Abstract

          Cardiac sarcoma treatment is challenging for surgeons because of frequent tumor recurrence and poor prognosis. In addition, optimal management of recurrences is not well established. The multi-targeted tyrosine kinase inhibitor, pazopanib, was recently approved for soft-tissue sarcoma. Herein, we present a case involving recurrent cardiac angiosarcoma where the patient survived for 2 years with complete remission of disease after repeated surgical resection and treatment with oral pazopanib. Based on our experience, aggressive surgical resection combined with pazopanib may be a valid treatment for recurrent cardiac angiosarcoma to improve patient survival.

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          Malignant primary cardiac tumors: review of a single institution experience.

          Audrey Moynihan, Jan Buckner, Luis F. Porrata … (2008)
          Primary cardiac sarcomas are uncommon. The authors undertook to review the Mayo Clinic's experience with primary cardiac sarcomas consisting of 34 patients seen over a 32-year period. The patient database at the Mayo Clinic was searched to identify patients with malignant tumors of the heart seen during the 32-year period between 1975 and 2007. Thirty-four patients with primary cardiac sarcomas were identified and their medical records reviewed for details pertaining to presenting symptoms, staging modalities, treatment approaches, and outcomes. Of the 34 patients, 17 were men and 17 were women. The median age was 44 years. The mean duration of symptoms at the time of diagnosis was 3.6 months. The most common histologic type was angiosarcoma (41%). The median follow-up for the entire group was 12 months (range, 0-61 months). The median survival for those who underwent a complete surgical excision was 17 months compared with 6 months for those in whom a surgical complete remission could not be achieved (P = .01). Patients with angiosarcoma had a lower survival compared with patients with other histologies (5 months vs 17 months; P = .01). The median survival of patients with metastatic disease was 5 months versus 15 months in patients without metastatic disease (P = .03 by the log-rank test). Cardiac sarcomas remain a rare but lethal disease. Compared with extracardiac sarcomas, the prognosis for patients with cardiac sarcomas remains very poor. A complete surgical excision should be performed if possible. Innovative treatment strategies are required. (c) 2008 American Cancer Society.
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            A 14-year retrospective review of angiosarcoma: clinical characteristics, prognostic factors, and treatment outcomes with surgery and chemotherapy.

            Matthew G Fury, Cristina R Antonescu, Kimberly Van Zee … (2005)
            Angiosarcoma is a rare vascular malignancy, and there are few published data to guide chemotherapy treatment decisions. We present a retrospective analysis of angiosarcoma encompassing all anatomic sites of disease presenting to a single institution over a 14-year period. Characteristics at presentation and prognostic factors are reviewed. For patients with unresectable disease, progression-free survival with various chemotherapy regimens is described. Pathological confirmation of all cases was performed before they were included in this analysis. One hundred twenty-five patients with angiosarcoma were seen and treated between January 1, 1990 and December 31, 2003. Angiosarcoma showed marked variation by anatomic site regarding gender ratio, median age at diagnosis, overall survival, and response to chemotherapy. Overall 5-year survival was 31% for angiosarcoma. Superficial depth and negative microscopic surgical margins correlated with longer overall survival, but tumor size did not reach significance as a prognostic factor. For unresectable angiosarcoma, doxorubicin based regimens yielded progression-free survival of 3.7-5.4 months. Paclitaxel achieved a progression-free survival of 6.8 months for scalp angiosarcoma and 2.8 months for sites below the clavicle. Angiosarcoma is an aggressive malignancy characterized by biologic heterogeneity at different anatomic sites and relative sensitivity to paclitaxel and doxorubicin.
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              Primary cardiac sarcomas: a retrospective study of the French Sarcoma Group.

              Nicolas Isambert, Isabelle Ray-Coquard, Antoine Italiano … (2014)
              Primary cardiac sarcomas (PCS) are rare tumours of dismal prognosis.
              Article 0 comments Cited 60 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Pathol
                Journal ID (iso-abbrev): Clin Pathol
                Journal ID (publisher-id): PAT
                Journal ID (hwp): sppat
                Title: Clinical Pathology
                Publisher: SAGE Publications (Sage UK: London, England )
                ISSN (Electronic): 2632-010X
                Publication date (Electronic): 21 February 2019
                Publication date Collection: Jan-Dec 2019
                Volume: 12
                Electronic Location Identifier: 2632010X19831261
                Affiliations
                [1-2632010X19831261]Department of Cardiovascular Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
                Author notes
                [*]Yoshiki Sawa, Department of Cardiovascular Surgery, Graduate School of Medicine, Osaka University, 2-15 Yamada-Oka, Suita 565-0871, Osaka, Japan. Email: sawa-p@ 123456surg1.med.osaka-u.ac.jp
                Article
                Publisher ID: 10.1177_2632010X19831261
                DOI: 10.1177/2632010X19831261
                PMC ID: 6546942
                SO-VID: 1976fdaf-5a45-47e7-b72c-f40ed4f41f2e
                Copyright © © The Author(s) 2019
                License:

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Date received : 3 January 2019
                Date accepted : 9 January 2019
                Categories
                Subject: Brief Report
                Custom metadata
                cover-date January-December 2019

                Keywords: cardiac angiosarcoma,pazopanib,angiogenesis
                Data availability:
                Keywords: cardiac angiosarcoma, pazopanib, angiogenesis

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