Cutaneous angiosarcoma of the head and face: a single-center analysis of treatment outcomes in 43 patients in Japan

Takamichi Ito, Hiroshi Uchi, Takeshi Nakahara, Gaku Tsuji, Yoshinao Oda, Akihito Hagihara, Masutaka Furue

For a better understanding of angiosarcoma, we summarized our 30-year experience of conventional treatment outcomes before the era of molecular-targeted therapy. We conducted a retrospective review of our 43 patients with cutaneous angiosarcoma of the head and face, and investigated the prognostic factors including the treatment strategy. Disease-specific survival (DSS) and event-free survival (EFS) were estimated using the Kaplan-Meier method, together with multivariate analyses using the Cox proportional hazard regression model. All patients were Japanese (25 males and 18 females), with a mean age of 72.1. For the initial treatment of the primary lesion, 34 patients underwent radiotherapy with or without taxanes (docetaxel and/or paclitaxel); only 6 patients underwent surgical excision. As the systemic adjuvant therapy, 19 patients were treated with taxanes and 15 with interleukin-2. Interestingly, patients who underwent the continued chemotherapy with taxanes had significantly prolonged DSS (5-year DSS, 57.0 vs. 19.6 %; median survival, 62.2 vs. 17.7 months; P = 0.0049) and EFS (5-year EFS, 34.9 vs. 5.6 %; median survival, 46.7 vs. 12.4 months; P = 0.0024) than the others. The continuous use of taxanes was also a prognostic factor in multivariate analyses. Neither radiotherapy nor surgical excision significantly influenced the patients' outcome. Among five patients who survived more than 5 years, three underwent surgical excision of the primary tumor or lung metastasis. Our results suggest that continued chemotherapy with taxanes is important for patient survival.