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Outcomes of surgery for dermatofibrosarcoma protuberans
C K Chang1, I A Jacobs, G I Salti
1Department of Surgery, Naples Community Hospital, Naples, FL, USA. ckchang@hotmail.com
Summary
Dermatofibrosarcoma protuberans (DFSP) recurrence can occur late, even after 5 years. Wide local excision with adequate margins is crucial for reducing recurrence rates in DFSP patients.
Area of Science:
- Oncology
- Surgical Pathology
- Dermatology
Background:
- Dermatofibrosarcoma protuberans (DFSP) is a rare, slow-growing cutaneous soft tissue sarcoma.
- Standard treatment involves wide local excision (≥3 cm margins) due to a high recurrence rate (up to 50%).
- Metastasis is rare and associated with fibrosarcomatous features.
Purpose of the Study:
- To review institutional experience regarding the time interval to recurrence of DFSP.
- To identify prognostic variables influencing DFSP recurrence.
- To evaluate the effectiveness of wide local excision in preventing DFSP recurrence.
Main Methods:
- Retrospective review of DFSP patients treated between 1968 and 2001.
- Surgical treatment included wide local excision with ≥3 cm margins.
- Statistical analysis using chi-square, Fisher's exact test, Kaplan-Meier method, and log-rank comparison.
Main Results:
- Median follow-up was 59 months; 5- and 10-year disease-free survival rates were 86% and 76%.
- Overall recurrence rate was 16.7%, with a mean time to recurrence of 38 months (range 1-100 months).
- Local regional recurrence occurred after 5 years in 30% of recurrent cases.
Conclusions:
- Wide local excision with adequate margins significantly reduces local regional recurrences in DFSP.
- Close patient surveillance is essential, extending beyond 5 years due to the possibility of late recurrences.