Outcomes after definitive treatment for cutaneous angiosarcomas of the face and scalp: Reevaluating the role of surgery and radiation therapy

Abstract

Introduction We investigated outcomes and prognostic factors for patients treated for cutaneous angiosarcoma (CA). Methods We conducted a retrospective review of patients treated for CA of the face and scalp from 1962 to 2019. All received definitive treatment with surgery, radiation (RT), or a combination (S‐XRT). The Kaplan–Meier method was used to estimate outcomes. Multivariable analyses were conducted using the Cox proportional hazards model. Results For the 143 patients evaluated median follow‐up was 33 months. Five‐year LC was 51% and worse in patients with tumors >5 cm, multifocal tumors, those treated pre‐2000, and with single modality therapy (SMT). These remained associated with worse LC on multivariable analysis. The 5‐year disease‐specific survival (DSS) for the cohort was 56%. Tumor size >5 cm, non‐scalp primary site, treatment pre‐2000, and SMT were associated with worse DSS. Conclusion Large or multifocal tumors are negative prognostic factors in patients with head and neck CA. S‐XRT improved outcomes.