Cutaneous Angiosarcoma of Head and Neck: A New Predictive Score for Locoregional Metastasis12

OBJECTIVES Cutaneous angiosarcoma of head and neck (cAS-HN) is a malignant neoplasm with deficient data on prognostic factors. The aim of this study is to present our monocenter database on cAS-HN so far and a new predictive score for locoregional metastasis (LRM). METHODS Retrospectively, tumor characteristics and outcome of 103 consecutive patients with cAS-HN were analyzed. The main predictors of LRM (identified by univariate and multivariate statistics) were combined to a LRM risk score. The prognostic values of stratification into high-, medium-, and low-risk groups concerning disease-specific survival (DSS), distant metastasis (DM), and progression-free survival (PFS) were evaluated. RESULTS LRM (n = 29) and control (n = 74) groups differed significantly concerning several tumor characteristics and outcome (DM, PFS, and DSS). Patients developing LRM showed 3-, 5-, and 10-year survival rates of 32%, 16%, and 11% (mean DSS time of 36.7 months [95% confidence interval (CI) 20.5-52.8]) compared to 81%, 73%, and 69% (mean DSS time of 292.4 months [95% CI 208.4-376.5]) in controls without LRM (P < .001). The main predictors were American Joint Committee on Cancer (AJCC) stage, tumor extent, and origin of the primary tumor. The LRM risk score revealed significant higher values for the LRM group [7.14 (SD 1.46) vs 4.88 (SD 1.89), P < .001]. The high-risk group showed significantly higher risk for DM and more unfavorable DSS and PFS. CONCLUSION The LRM risk score is a simple way to estimate the risk for LRM and DM, to stage patients, and to determine treatment options.