Prognostic features in angiosarcoma of the head and neck: a retrospective monocenter study

Abstract

Background: Cutaneous angiosarcoma of the head and neck (cAS-HN) is a rare malignancy with poor survival. Most of the histological markers and grading were not proven to be significant for prediction of outcomes in cAS-HN. This study aimed to find prognostic clinical features and histologic markers for cAS-HN.

Material and methods: We retrospectively analysed primary cAS-HN's seen in a single institution between 1980 and 2009. Clinical data and specific histologic characteristics were assessed. Outcome parameters were analysed using uni- and multivariate statistics.

Results: 80 patients (mean age 71.4 (SD 14.4) years, average follow-up time 55.3 (SD 74.4) months) were included. 5-year DSS rate was 62%. Univariate analysis revealed the extent of primary tumour (affecting more than one anatomical region), incomplete resection and initial metastatic disease as significant (p < 0.05) predictors for unfavourable disease specific survival (DSS) rates and time. Multivariate analysis confirmed age over 70 years, incomplete resection and initially distant metastasis influencing outcome adversely. Analysis of specific histological markers in 37 cases found patterns of growth (solid areas greater than 80%) associated with better survival (p = 0.011).

Conclusion: In conclusion age, number of affected regions, initial metastasis, complete initial resection and pattern of growth significantly affected mortality rates.

Keywords: Angiosarcoma; Grading; Head and neck; Histology; Outcome; Prognosis.