Outcomes after definitive treatment for cutaneous angiosarcoma of the face and scalp

Abstract

Background To retrospectively evaluate outcomes in patients with cutaneous angiosarcoma of the face/scalp treated curatively with surgery, radiation therapy (RT), or a combination of surgery and RT. Methods 70 patients with non-metastatic angiosarcoma underwent surgery, RT, or combined-modality therapy. Of these, 20 (29%) were treated with surgery alone, 27 (39%) with RT alone, and 23 (33%) with combined-modality therapy. 44 patients received chemotherapy, either neo-adjuvantly or adjuvantly or both. Results Median follow-up was 2.1 years. The overall survival (OS) rate was 43% at 5 years, and disease specific survival was 46% at 5 years. Tumor size > 5 cm and satellitosis were prognostic for inferior OS and DSS. Combined-modality therapy (vs. surgery alone or RT alone) was associated with improved OS, DSS, and local control (LC). Conclusion Primary local therapy with combined-modality therapy was associated with improved LC, OS, and DSS for patients with angiosarcoma of the face/scalp.

Treatment and prognosis of angiosarcoma of the scalp and face: a retrospective analysis of 48 patients

“…In terms of radiation dose, several authors generally recommend approximately 60 Gy in 30 fractions for treatment of a primary tumour [3,14]. In the current study, of the patients treated with radiotherapy only (macroscopic disease), in-field recurrence occurred in 4 of 11 patients (36.4%) treated with less than 70 Gy, while none of 14 patients treated with 70 Gy or more had in-field recurrence.…”

“…Despite intensive therapies, local recurrences in patients with angiosarcoma of the scalp and face are frequent, ranging in frequency from 35% to 86% [7,9,13]. For local therapy, several authors indicated that radiotherapy as well as the combination of surgery and radiotherapy were significantly associated with improved LC in patients with angiosarcoma of the scalp and face [1,7,9,14]. However, the optimal management of radiotherapy, such as radiation field and radiation dose, has not been clarified.…”

“…Since several reports have provided proof of a treatment efficacy of radiotherapy and surgery for patients with angiosarcoma of the scalp and face, this treatment combination has been recommended as an ideal treatment of these tumours [1,6,7,14]. Guadagnolo et al [14] analysed 70 patients with angiosarcoma of the scalp and face and found that combined surgery and radiotherapy was associated with improved OS, diseasespecific survival and LC compared with surgery or radiotherapy alone. Hodgkinson et al [1] demonstrated that 2 of 13 patients treated with both surgery and radiotherapy survived for more than 5 years.…”

“…In order to reduce the marginal and out-field recurrence, other techniques, such as intensity-modulated radiotherapy and high dose rate brachytherapy with a surface mould technique, may be necessary to achieve optimal results [15,16]. Several previous studies have suggested potential prognostic factors associated with tumour size, tumour type, age and radiotherapy use in patients with angiosarcoma of the scalp and face [2,7,13,14,17]. In the current study, concerning patient characteristics, PS and number of tumours were independent prognostic factors for OS.…”

Treatment of cutaneous angiosarcoma of the scalp and face in the Chinese patients: local experience at a regional hospital in Hong Kong

“…As shown in Table 3, five of six studies support the beneficial role of RT. 4,[6][7][8]10,11 Guadagnolo et al 7 advocated simple resection of the gross tumour to facilitate noncomplicated reconstruction and thus expedite RT. Two-staged surgery was discouraged.…”