Recommendations for Therapeutic Decisions of Angiosarcoma of the Scalp and Face

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The aim of this study was to elucidate the therapeutic decision process of angiosarcoma of the scalp and face including treatment modalities, tumor size, tumor grade, and resection margins.

In a PubMed search, 170 abstracts were read and 32 full text articles were reviewed. Among them, 19 articles were analyzed.

Overall, survival did not differ significantly between the surgery group (23.6 ± 11.0 months) and the no surgery group (22.2 ± 8.0 months) (P = 0.386 [t test]). Among the patients who had undergone an operation, 64.4% had residual cancer cells at their surgical margin. Survival did not differ significantly according to the positive or negative resection margin (P > 0.05 [t tests]). Overall survival of the radiation therapy and chemotherapy group (37.0 ± 0.0 months) was significantly longer than that of the radiation therapy group (22.7 ± 7.6 months) or the chemotherapy group (15.1 ± 4.6 months). Overall survival, local recurrence-free survival, and distant metastasis-free survival were significantly longer in the T1 group (the tumor size being the same or smaller than 5 cm) than the T2 group (tumor larger than 5 cm) (P < 0.05 [t test]). The 2-year survival rates and the 5-year survival rates were significantly longer in the T1 group than in the T2 group (P < 0.000 [t test]). The overall survival of low grade tumor group (44.8 ± 10.4 months) was more than 2 times longer than the high-grade tumor group (22.3 ± 6.8 months) (P = 0.000 [t test]).

Surgeons should remember that they do not have to try to remove all the cancer cells in the operation theater. A combination of radiation and chemotherapy can bring better results than any single regimen. Lastly, early diagnosis and early treatment are essential.

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