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Updated: Feb 5, 2026
Survivable Stereotaxic Surgery in Rodents
Published on: October 6, 2008
The importance of surgery in scalp angiosarcomas
Richard J Cassidy1, Jeffrey M Switchenko2, Melinda L Yushak3
1Department of Radiation Oncology, Atlanta, GA, USA; Department of Radiation Oncology of the Winship Cancer Institute of Emory University, Atlanta, GA, USA.
Background:
Scalp angiosarcomas (SA) are rare, representing <1% of soft tissue sarcomas. The optimal management of these tumors is unknown, with management based on small case series. We sought to assess the impact of different therapies on overall survival (OS), the practice patterns nationally, and identify factors associated with OS for non-metastatic scalp angiosarcomas.
Methods:
A prospectively maintained database was used to identify non-metastatic scalp angiosarcomas who received some form of definitive therapy. Logistics regression, Kaplan-Meier, and Cox proportional-hazard models were utilized.
Results:
A total of 589 patients met study entry criteria with a median follow-up of 4.2 years. The majority (482 patients, 81.8%) had upfront definitive resection and an additional 317 patients (65.8%) received postoperative radiation. Of the 107 patients who didn't have surgery, the majority (65 patients, 60.7%) received definitive radiation and 42 patients (39.3%) received radiation and chemotherapy. One-year and five-year survival estimates for patients not receiving definitive surgery were 68.0% (95%CI: 57.5-76.4) and 18.0% (95%CI: 10.2-27.5) respectively compared to 78.2% (95%CI: 74.0-81.9) and 34.1% (95%CI: 28.9-39.3) for patients receiving definitive surgery (p < 0.01). On multivariable analysis, age ≥65 years, tumor size ≥5 cm, and not receiving definitive surgery was associated with worse OS.
Conclusions:
The majority of patients with non-metastatic scalp angiosarcomas had upfront definitive surgery, with a subsequent improvement in OS, including when accounting for other patient and tumor factors. Postoperative radiation was frequently given. Our large series confirmed age and tumor size as prognostic factors for this rare disease.
Insights
Definitive surgery improves overall survival for scalp angiosarcomas. Factors like age and tumor size also impact outcomes in this rare cancer.
Area of Science:
- Oncology
- Surgical Oncology
- Radiation Oncology
Background:
- Scalp angiosarcomas (SA) are rare soft tissue sarcomas, comprising less than 1% of all sarcomas.
- Optimal management strategies for SA are not well-established, often relying on limited case series.
- This study investigates treatment patterns and survival outcomes for non-metastatic SA.
Purpose of the Study:
- To assess the impact of various therapies on overall survival (OS) for scalp angiosarcomas.
- To analyze national practice patterns in the management of non-metastatic SA.
- To identify prognostic factors influencing OS in patients with SA.
Main Methods:
- Utilized a prospectively maintained database of patients with non-metastatic scalp angiosarcomas receiving definitive therapy.
- Employed logistic regression, Kaplan-Meier, and Cox proportional-hazards models for statistical analysis.
- Included 589 patients with a median follow-up of 4.2 years.
Main Results:
- Upfront definitive resection was performed in 81.8% of patients, with 65.8% receiving postoperative radiation.
- Patients not undergoing surgery had significantly lower 1-year and 5-year survival rates (68.0% and 18.0%) compared to those receiving surgery (78.2% and 34.1%).
- Multivariable analysis identified age ≥65 years, tumor size ≥5 cm, and absence of definitive surgery as predictors of worse OS.
Conclusions:
- Upfront definitive surgery for non-metastatic scalp angiosarcomas is associated with improved overall survival.
- Postoperative radiation therapy is frequently utilized in the management of SA.
- Age and tumor size are confirmed prognostic factors for scalp angiosarcomas.
