2. Academic Validation
  3. Angiosarcoma of the scalp and face: the Mayo Clinic experience

Angiosarcoma of the scalp and face: the Mayo Clinic experience

  • JAMA Otolaryngol Head Neck Surg. 2015 Apr;141(4):335-40. doi: 10.1001/jamaoto.2014.3584.
Samir H Patel 1,  Richard E Hayden 2,  Michael L Hinni 2,  William W Wong 1,  Robert L Foote 3,  Shadi Milani 4,  Qing Wu 5,  Stephen J Ko 6,  Michele Y Halyard 1
Affiliations

Affiliations

  • 1 Department of Radiation Oncology, Mayo Clinic, Scottsdale, Arizona.
  • 2 Department of Otolaryngology-Head and Neck Surgery/Audiology, Mayo Clinic Hospital, Phoenix, Arizona.
  • 3 Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.
  • 4 medical student at Midwestern University, Phoenix, Arizona.
  • 5 Division of Health Sciences Research, Mayo Clinic, Scottsdale, Arizona.
  • 6 Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida.
PMID: 25634014 DOI: 10.1001/jamaoto.2014.3584
Abstract

Importance: The etiology and optimal treatment are unknown for angiosarcoma, an aggressive malignant tumor that affects vascular endothelial cells and can be mistaken for benign lesions such as hemangioma.

Objective: To determine the treatment outcomes of patients with angiosarcoma of the face or scalp treated with a combination of surgery, radiation therapy, and/or chemotherapy.

Design, setting, and participants: Retrospective study of 55 patients with angiosarcoma of the face or scalp treated between January 1, 1973, and December 31, 2012, at a tertiary-care academic medical institution.

Interventions: Surgery, radiation therapy, and/or chemotherapy.

Main outcomes and measures: Locoregional control (LRC), recurrence-free survival (RFS), and overall survival (OS).

Results: Fifty-five patients had angiosarcoma localized to the face or scalp. Forty of these patients (73%) received a combination of surgery, radiation therapy, and/or chemotherapy. Eight patients (15%) were treated with surgery alone, 1 (2%) with radiation alone, 5 (9%) with chemotherapy alone, and 1 (2%) with observation alone. Median (range) follow-up for surviving patients was 25.2 (4.7-227.1) months. Five-year LRC, RFS, and OS (95% CI) were 18% (7%-32%), 16% (6%-31%), and 38% (21%-54%), respectively. Of 36 patients with failed treatment, 34 had failure in a local and/or regional site. On univariate analysis, the use of multimodality therapy (vs no multimodality therapy) was associated with higher 5-year LRC (95% CI) (20% [3%-37%] vs 11% [0%-29%]; P = .04), higher RFS (19% [2%-36%] vs 10% [0%-27%]; P = .02), and higher OS (46% [26%-66%] vs 16% [0%-43%]; P = .04). Age 70 years or older (vs <70 years) was associated with lower 5-year LRC (95% CI) (5% [0%-14%] vs 48% [23%-74%]; P = .02) and lower RFS (5% [0%-13%] vs 49% [24%-75%]; P = .04). Radiation therapy (vs no radiation therapy) was associated with higher 5-year LRC (95% CI) (20% [3%-36%] vs 12% [0%-32%]; P = .02) and higher RFS (19% [2%-35%] vs 12% [0%-31%]; P = .004). On multivariable analysis, age younger than 70 years (vs ≥70 years) was associated with improved 5-year LRC (95% CI) (48% [23%-74%] vs 5% [0%-14%]; P = .03) and RFS (49% [24%-75%] vs 49% [24%-75%]; P = .04).

Conclusions and relevance: Multimodality therapy for angiosarcoma is associated with improved LRC, RFS, and OS. Younger patients with resectable disease undergoing multimodality therapy for angiosarcoma had the best clinical outcomes.

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