ANGIOSARCOMA OF THE HEAD AND NECK - THE UCLA EXPERIENCE 1955 THROUGH 1990

Between 1955 and 1990, 28 patients with angiosarcoma of the head and n eck were seen at UCLA Medical Center, Los Angeles, Calif. Half the les ions arose on the scalp; the remainder occurred in the soft tissues of the face and neck. Nine patients presented with multifocal disease. F ollow-up ranged from 3 to 159 months, with a median of 32 months. The overall prognosis was poor, with a 5-year disease-free survival of 26% (7/27 patients). Of 21 patients having recurrences after primary trea tment, 90% (19/21 patients) had a component of local failure. Distant metastasis had developed in nine patients at last follow-up. Of patien ts treated initally with surgery alone, 8% (1/12 patients) remain dise ase free vs 67% (4/6 patients) who received post-operative radiation t herapy, with or without chemotherapy. Only one (14%) of seven patients treated primarily with radiation therapy with or without chemotherapy was rendered disease free. Angiosarcoma usually presents with high-gr ade histologic features and frequently with multifocal disease. There is propensity for both local recurrence and distant metastasis. Our re sults and a review of the literature suggest that combined modality th erapy offers the best chance for long-term control in patients with an giosarcoma of the head and neck.