Prognostic factors of survival in treatment of scalp angiosarcoma in Chinese population

BackgroundScalp angiosarcoma is a rare soft tissue sarcoma with a very poor prognosis and high mortality. Due to its low incidence, prognostic factors and treatment strategies are not well defined.ObjectiveThis study aims to report our long-term results in terms of survival and prognostic factors affecting survival through retrospective analysis of 38 consecutive patients with scalp angiosarcoma who underwent treatment at two different plastic centers in Hong Kong.ResultThe overall survival rate for 1, 3, and 5 years of maximally treated patients was 56%, 24%, and 12%, respectively. Univariate analysis with Cox regression model showed that age >70 years (risk ratio, RR 5.0; p = 0.02), satellite lesion on presentation (RR 8.4, p = 0.02), and tumor of size >5 cm (RR 2.79, p = 0.05) were factors affecting the overall survival. Multivariate analysis showed that only the involved deep resection margin was a significant risk factor (RR 8.6, p = 0.02) However, univariate analysis showed that the involved deep resection margin (RR 10.2, p = 0.01) and satellite lesion on presentation (RR 0.73, p = 0.01) were factors affecting disease-free survival. Besides, satellite lesion on presentation predicted local recurrence on univariate analysis (RR 2, p = 0.01).ConclusionsThe prognosis in terms of overall survival and local disease control was poor with a 5-year survival rate of 12% in maximally treated patients.