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Improving Sarcoma Care Globally: Access, Equity, Advocacy and Policy

(P 145) OUTCOMES OF BREAST ANGIOSARCOMA UNDERGOING TREATMENT IN A SPECIALIST CENTRE

Location: The Liffey, Level 1

    Author(s)

  • Anjum Shah Mostofa

    Medical Student
    Univerity College London and King's College London
    Luton, England, United Kingdom

    • Co-Author(s)

  • MA

    Mahbubl Ahmed, MRCP PhD FRCR

    Dr Mahbubl Ahmed MRCP PhD FRCR
    University College London Hospital
    London, England, United Kingdom

Objective: Breast angiosarcoma (BAS) is a rare cancer and typically occur secondary to radiotherapy of the breast. NHS England service specification has recommended early referral to sarcoma multi-disciplinary meetings. Surgical resection is the most important component of treatment. Clinical outcomes are known to be improved when treatment is undertaken by a specialist multidisciplinary team (MDT). However, there are no studies that compare patient outcomes in specialist centres compared to non-specialist centres. This retrospective study will compare outcomes when treatment takes place in a specialist hospital (containing a sarcoma MDT) to non-specialist hospitals (does not host a specialist’s sarcoma MDT).

Methods: All patients diagnosed with BAS and referred to London Sarcoma Services between 2008-2022 were identified from clinical databases. Patient characteristics and clinical outcomes were analysed using Fisher’s exact test and Kaplan-Meier curves.

Results: 23 women underwent surgery as their primary treatment (12 non-specialist group v 11 specialist group). In non-specialist hospitals, more patient developed local recurrence (LR) and metastasis (p=0.003 and p=0.027 respectively). Local progression-free survival (L-PFS) was significantly longer in the specialist group v non-specialist group: mean 44.75 months (95% CI 18.73-70.77) versus 115 months (95% CI 15.52–84.58) respectively (P = 0.011) (figure 1). Significantly more patients required >1 surgery in the non-specialist group compared to the specialist group, with longer L-PFS observed in patients receiving only 1 surgery (median 105 (95%CI 0-229.71) versus 15 (95%CI 5.703-24.297) (p= 0.002)) (figure 2). There was no impact on overall survival between the 2 groups.

Conclusion: Undergoing initial BAS surgery in a specialist hospital reduces the risk of LR, metastasis and for multiple operations. Longer L-PFS are observed in specialist hospitals. Due to short follow up there was no difference in survival. Therefore, treatment whenever possible should take place in specialist centres to improve outcomes.