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Dermatofibrosarcoma protuberans of the head and neck
A Stojadinovic1, H M Karpoff, C R Antonescu
1Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Annals of Surgical Oncology
|October 18, 2000
Summary
Wide margin resection improves outcomes for head and neck dermatofibrosarcoma protuberans (DFSP). Frozen section analysis is unreliable for assessing resection margins in DFSP.
Area of Science:
- Oncology
- Surgical Pathology
- Head and Neck Surgery
Background:
- Dermatofibrosarcoma protuberans (DFSP) is a rare, locally infiltrative, low-grade sarcoma.
- Head and neck DFSP presents unique clinical challenges due to anatomical complexity.
- Understanding factors predicting local control is crucial for optimizing treatment strategies.
Purpose of the Study:
- To define the clinical behavior of head and neck DFSP.
- To evaluate the diagnostic accuracy of frozen section analysis in DFSP.
- To identify prognostic factors for local tumor control.
Main Methods:
- Retrospective review of 33 head and neck DFSP cases treated between 1964 and 1999.
- Analysis of clinical and pathological data, including tumor size, location, and margin status.
- Statistical analysis using Fisher's exact or chi-squared tests.
Main Results:
- Wide margin resection (≥2 cm) was associated with negative histological margins and a trend toward improved recurrence-free survival.
- Deep tumors had a higher likelihood of positive resection margins compared to superficial lesions.
- Frozen section analysis demonstrated low sensitivity (43%) and a high false-negative rate (57%) for margin assessment.
Conclusions:
- Wide margin resection is a critical factor for achieving negative histological margins and favorable local control in head and neck DFSP.
- Frozen section analysis is not a reliable method for intraoperative assessment of DFSP resection margins.
- Further research into optimal surgical techniques and adjuvant therapies for DFSP is warranted.