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Role of surgery in the management of postmastectomy extremity angiosarcoma (Stewart‐Treves syndrome)
Author(s) -
Grobmyer Stephen R.,
Daly John M.,
Glotzbach Raymond E.,
Grobmyer Albert J.
Publication year - 2000
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/(sici)1096-9098(200003)73:3<182::aid-jso14>3.0.co;2-n
Subject(s) - medicine , lymphedema , angiosarcoma , amputation , surgery , mastectomy , chemotherapy , radiation therapy , overall survival , cancer , breast cancer
Stewart‐Treves syndrome (STS) is the rare occurrence of angiosarcoma in a setting of postmastectomy upper extremity lymphedema. A collective comparison of outcomes following various initial treatment options in STS has not previously been reported. We reviewed 160 cases of STS reported in the literature since 1966. We analyzed the relationship between initial treatment and survival in all 92 of these patients for whom detailed treatment and outcome data had been reported. There was no significant difference in survival comparing those initially treated with wide excision (n = 16) and those treated with amputation (n = 45) ( P = 0.40). Even in the setting of initial surgical treatment, overall long‐term survival was poor (<40%). There have been even fewer long‐term survivors among those treated initially with regional chemotherapy (n = 7) or radiation therapy (n = 24). An update on STS and a discussion of recent advances in the understanding of its molecular pathogenesis that may result in future treatment improvements are presented. J. Surg. Oncol. 2000;73:182–188. © 2000 Wiley‐Liss, Inc.