Radiation Oncology/Sarcoma/Sarcomas of the Aorta

Sarcomas of the Aorta U. Colorado/Moffitt 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