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Dermatofibrosarcoma protuberans: how wide is wide in surgical excision?
E Vandeweyer1, N De Saint Aubain Somerhausen, M Gebhart
1Department of Plastic and Reconstructive Surgery, Jules Bordet Cancer Institute, Brussels, Belgium. vandeweyere@skynet.be
Acta Chirurgica Belgica
|February 4, 2003
Summary
Dermatofibrosarcoma protuberans (DFSP) treatment may not require wide margins if histological margins are clear. This study found a low recurrence rate in DFSP patients with confirmed clear histological margins, regardless of gross margin size.
Area of Science:
- Oncology
- Surgical Pathology
- Dermatology
Background:
- Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive skin tumor.
- High recurrence rates are reported, often necessitating wide surgical excision (≥3 cm margins).
Purpose of the Study:
- To evaluate the necessity of wide gross margins for DFSP treatment.
- To determine if clear histological margins are sufficient for local tumor control.
Main Methods:
- Retrospective analysis of 18 DFSP patients.
- Variable gross surgical margins were assessed.
- Histological margin status was confirmed for all cases.
- Mean follow-up of 52.1 months.
Main Results:
- Only one patient (5.5%) experienced local recurrence.
- The recurrent case involved a large (14 cm) sarcomatous DFSP variant.
- All patients achieved confirmed clear histological margins.
Conclusions:
- Histological margin assessment is critical for DFSP local control.
- Theoretical wide margin rules may be less important than confirmed clear histological margins.
- Achieving clear histological margins appears to significantly reduce DFSP recurrence rates.