TY - JOUR
T1 - Surgical Outcomes of Primary Dermatofibrosarcoma Protuberans
T2 - A Retrospective, Multicenter Study
AU - Houdek, Matthew T.
AU - Tsoi, Kim M.
AU - Mallett, Katherine E.
AU - Claxton, Ryan M.
AU - Ferguson, Peter C.
AU - Griffin, Anthony M.
AU - Baum, Christian L.
AU - Brewer, Jerry D.
AU - Rose, Peter S.
AU - Wunder, Jay S.
N1 - Publisher Copyright:
© 2022, Society of Surgical Oncology.
PY - 2022/12
Y1 - 2022/12
N2 - 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.
AB - 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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U2 - 10.1245/s10434-022-12351-0
DO - 10.1245/s10434-022-12351-0
M3 - Article
C2 - 35933538
AN - SCOPUS:85135463579
SN - 1068-9265
VL - 29
SP - 8632
EP - 8638
JO - Annals of surgical oncology
JF - Annals of surgical oncology
IS - 13
ER -