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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2022

06-08-2022 | Dermatofibrosarcoma Protuberans | Sarcoma

Surgical Outcomes of Primary Dermatofibrosarcoma Protuberans: A Retrospective, Multicenter Study

Authors: Matthew T. Houdek, MD, Kim M. Tsoi, MD, PhD, Katherine E. Mallett, MD, Ryan M. Claxton, BS, Peter C. Ferguson, MD, Anthony M. Griffin, MSc, Christian L. Baum, MD, Jerry D. Brewer, MD, Peter S. Rose, MD, Jay S. Wunder, MD

Published in: Annals of Surgical Oncology | Issue 13/2022

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Abstract

Background

Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive tumor with a low rate of metastatic disease. Previous series have shown a superiority of Mohs micrographic surgery (MMS) compared with wide local excision (WLE). Likewise, there is paucity of data examining the long-term follow-up of patients.

Objective

The purpose of the current study was to examine the outcome of surgical treatment of primary DFSP of the trunk and extremities.

Methods

We reviewed 236 patients (115 females, 121 males, mean age 41 ± 15 years) undergoing MMS (n = 81, 34%) or WLE (n = 155, 66%) to treat a primary DFSP. Mean tumor size and follow-up was 4 ± 2 cm and 7 years, respectively. Final margins were negative in 230 (97%) patients.

Results

There was no difference (p > 0.05) in patient age, sex, tumor size, negative margin excision, or history of a previous inadvertent excision between patients who underwent WLE and those undergoing MMS. There were two cases of local recurrence and two cases of metastasis, with no difference in the 5-year local recurrence-free survival (98% vs. 99%, p = 0.69) or metastatic-free survival (98% vs. 100%, p= 0.27) between WLE and MMS.

Conclusion

There was no difference in oncologic outcome comparing MMS with WLE for DFSP outside the head and neck. The goal of treatment for DFSP is to achieve a negative margin, regardless of surgical treatment modalities. A ‘less is more’ approach to follow-up can likely be taken for patients with completely resected DFSP in easy-to-examine anatomical areas. In these patients, no formal follow-up should be required.
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Metadata
Title
Surgical Outcomes of Primary Dermatofibrosarcoma Protuberans: A Retrospective, Multicenter Study
Authors
Matthew T. Houdek, MD
Kim M. Tsoi, MD, PhD
Katherine E. Mallett, MD
Ryan M. Claxton, BS
Peter C. Ferguson, MD
Anthony M. Griffin, MSc
Christian L. Baum, MD
Jerry D. Brewer, MD
Peter S. Rose, MD
Jay S. Wunder, MD
Publication date
06-08-2022
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 13/2022
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-022-12351-0

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