Intensified Adjuvant Treatment for High-Risk Resected Cutaneous Angiosarcoma of the Head and Neck

Authors

Muhammad El Shatanofy, Department of Otolaryngology, The George Washington University Hospital, Washington, District of Columbia, USA.
Punam Thakkar, Department of Otolaryngology, The George Washington University Hospital, Washington, District of Columbia, USA.
Vishal Patel, Department of Dermatology, The George Washington University Hospital, Washington, District of Columbia, USA.
Arjun Joshi, Department of Otolaryngology, The George Washington University Hospital, Washington, District of Columbia, USA.
Joseph Goodman, Department of Otolaryngology, The George Washington University Hospital, Washington, District of Columbia, USA.
Robert Siegel, Department of Hematology Oncology, The George Washington University Hospital, Washington, District of Columbia, USA.
Faysal Haroun, Department of Hematology Oncology, The George Washington University Hospital, Washington, District of Columbia, USA.
Martin Ojong-Ntui, Department of Radiation Oncology, The George Washington University Hospital, Washington, District of Columbia, USA.
Sharad Goyal, Department of Radiation Oncology, The George Washington University Hospital, Washington, District of Columbia, USA.
Julie Bauman, Cancer Center, The George Washington University Hospital, Washington, District of Columbia, USA.
Yuan James Rao, Department of Radiation Oncology, The George Washington University Hospital, Washington, District of Columbia, USA.

Document Type

Journal Article

Publication Date

7-19-2023

Journal

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

DOI

10.1002/ohn.429

Keywords

NCDB; angiosarcoma; chemoradiation; cutaneous angiosarcoma; head and neck

Abstract

OBJECTIVE: Previous studies have highlighted the poor survival of patients with cutaneous angiosarcoma of the head and neck. Therapeutic options are limited, and effective treatment strategies are yet to be discovered. The objective of this study is to evaluate overall survival following intensified adjuvant treatment for high-risk resected angiosarcoma of the head and neck. STUDY DESIGN: Retrospective observational. SETTING: National Cancer Database (NCDB). METHODS: Patients diagnosed with nonmetastatic cutaneous angiosarcoma of the head and neck from 2004 to 2016 were identified by NCDB. We retrospectively compared demographics and overall survival between patients who received surgery and radiation therapy (SR) and patients who received surgery and chemoradiation (SRC). The χ test, Kaplan-Meier method, and Cox regression models were used to analyze data. RESULTS: A total of 249 patients were identified, of which 79.5% were treated with surgery and radiation alone and 20.5% were treated with surgery and chemoradiation. The addition of chemotherapy, regardless of the sequence of administration, was not associated with significantly higher overall survival. Factors associated with worse survival in both groups included positive nodal status and positive margins. Patients with positive nodes had higher overall survival with radiation doses >50.4 Gy compared to ≤50.4 Gy (hazard ratio: 2.93, confidence interval: 1.60-5.36, p < 0.001). CONCLUSION: Adjuvant chemotherapy was not significantly associated with higher overall survival for resected nonmetastatic angiosarcoma of the head and neck. Higher radiation doses appear to be prognostic for high-risk diseases.

APA Citation

El Shatanofy, Muhammad; Thakkar, Punam; Patel, Vishal; Joshi, Arjun; Goodman, Joseph; Siegel, Robert; Haroun, Faysal; Ojong-Ntui, Martin; Goyal, Sharad; Bauman, Julie; and Rao, Yuan James, "Intensified Adjuvant Treatment for High-Risk Resected Cutaneous Angiosarcoma of the Head and Neck" (2023). GW Authored Works. Paper 3059.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3059

Department

Radiology