Angiosarcoma of the head and neck. The UCLA experience 1955 through 1990
R. J. Mark, L. M. Tran, J. Sercarz, Y. S. Fu, T. C. Calcaterra and G. F. Juillard
Radiation Medical Group, San Diego, California.
Between 1955 and 1990, 28 patients with angiosarcoma of the head and neck
were seen at UCLA Medical Center, Los Angeles, Calif. Half the lesions
arose on the scalp; the remainder occurred in the soft tissues of the face
and neck. Nine patients presented with multifocal disease. Follow-up ranged
from 3 to 159 months, with a median of 32 months. The overall prognosis was
poor, with a 5-year disease-free survival of 26% (7/27 patients). Of 21
patients having recurrences after primary treatment, 90% (19/21 patients)
had a component of local failure. Distant metastasis had developed in nine
patients at last follow-up. Of patients treated initially with surgery
alone, 8% (1/12 patients) remain disease free vs 67% (4/6 patients) who
received postoperative radiation therapy, with or without chemotherapy.
Only one (14%) of seven patients treated primarily with radiation therapy
with or without chemotherapy was rendered disease free. Angiosarcoma
usually presents with high-grade histologic features and frequently with
multifocal disease. There is propensity for both local recurrence and
distant metastasis. Our results and a review of the literature suggest that
combined modality therapy offers the best chance for long-term control in
patients with angiosarcoma of the head and neck.
