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

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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. 17.7months; P=0.0049) and EFS (5-year EFS, 34.9 vs. 5.6%; median survival, 46.7 vs. 12.4months; 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 5years, three underwent surgical excision of the primary tumor or lung metastasis. Our results suggest that continued chemotherapy with taxanes is important for patient survival.