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- W2288442720 abstract "10067 Background: Surgical management of cutaneous angiosarcoma (AS) of the head and neck (HN) in the absence of adjuvant therapy is associated with rapid recurrence and median survival of <30 mo. We reviewed the results of our experience with multimodality therapy. Methods: Of 395 patients (pts) with primary AS referred to our institution between 1990 and 2009, 80 (20%) had HN AS. We analyzed the prognostic value of tumor, patient, and treatment variables on progression-free and overall survival (PFS, OS) in the subset of 47 pts who underwent primary treatment at our institution. OS and PFS were estimated by the Kaplan-Meier technique and compared using a two- sided log-rank test. Results: In this cohort, median age was 72 years, 72% were men, median tumor size was 3cm (range 1–16cm), 37% were multifocal, and 47% were high-grade. Thirty-two pts (68%) were treated with 2 (20 pts) or 3 (12 pts) modalities. Among the 26 pts (55%) who underwent surgery, margins were microscopically positive in 12 (46%). Tumor progression after therapy was loco-regional in 22 pts (47%) and distant in 10 pts (21%). Median (5-yr) PFS and OS were 16mo (11%) and 40mo (35%), respectively. Pattern of progression did not impact PFS or OS. Although not statistically significant, median OS trended in favor of surgery over no surgery (59mo vs. 31mo) and local over systemic therapy (76mo vs. 40mo). Tumor size was a significant prognostic factor; pts with T1 (v. T2) tumors had better median PFS (23mo vs. 9mo, p<0.0001) and OS (76mo vs. 47mo, p=0.04). The sequence of surgery and radiation did not affect PFS in pts undergoing both, but median OS was better in pts who had surgery first (60mo vs. 40mo, p<0.05). Conclusions: HN AS remains a highly aggressive malignancy with a propensity for recurrence. AJCC T stage is associated with PFS and OS. Observed trends may be secondary to pt selection bias. While the median OS observed after our multimodality approach is better than historic controls, larger studies are necessary to determine which patients may benefit from multi-modality therapy, and in which order optimal outcomes are observed. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Novartis" @default.
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- W2288442720 date "2010-05-20" @default.
- W2288442720 modified "2023-10-18" @default.
- W2288442720 title "Cutaneous angiosarcoma of the head and neck." @default.
- W2288442720 doi "https://doi.org/10.1200/jco.2010.28.15_suppl.10067" @default.
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