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Dermatofibrosarcoma protuberans: recurrence is related to the adequacy of surgical margins
S Ten Heuvel1, A Suurmeijer, E Pras
1Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, P. O. Box 30.001, 9700 RB Groningen, The Netherlands.
Introduction:
The aim of the study was to investigate the results of surgical treatment in primary and recurrent dermatofibrosarcoma protuberans (DFSP), with respect to local tumor control.
Patients And Methods:
Thirty-eight patients were treated between 1971 and 2005 at the University Medical Center Groningen (UMCG). Thirty patients presented with primary disease (79%) and 8 patients with locally recurrent disease (21%). The treatment consisted of surgical resection and in case of marginal or positive resection margins (R1 resection) adjuvant radiotherapy.
Results:
Adequate surgical margins as a single modality was associated with 100% local control in all primary DFSPs. Two patients whose resection specimens had microscopically positive resection margins had withdrawn from adjuvant radiotherapy and developed local recurrence (LF rate 7%). Two of the 8 patients referred with a local recurrence developed a second recurrence (LF rate 25%); one of these patients developed distant disease and ultimately died of systemic disease. None of the five patients with DFSP-FS developed LF after treatment at the UMCG. After a median follow-up of 89 (12-271) months, the 10-year disease-free survival was 85% and the 10-year disease specific survival was 100%.
Conclusion:
After wide surgical resection of a DFSP or DFSP-FS, or an R1 resection combined with adjuvant radiotherapy the risk of local recurrence is extremely low.
Insights
Surgical treatment, including wide resection or R1 resection with adjuvant radiotherapy, offers excellent local control for dermatofibrosarcoma protuberans (DFSP). This approach significantly minimizes the risk of tumor recurrence.
Area of Science:
- Oncology
- Surgical Oncology
- Dermatopathology
Background:
- Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue sarcoma.
- Effective local tumor control is crucial for managing DFSP, particularly in primary and recurrent cases.
Purpose of the Study:
- To evaluate the efficacy of surgical treatment for primary and recurrent dermatofibrosarcoma protuberans (DFSP).
- To assess local tumor control rates following surgical resection and adjuvant radiotherapy.
Main Methods:
- Retrospective analysis of 38 patients treated between 1971 and 2005.
- Surgical resection as the primary treatment modality.
- Adjuvant radiotherapy administered for marginal or positive resection margins (R1 resection).
Main Results:
- 100% local control achieved with adequate surgical margins in primary DFSP.
- A low local recurrence rate (7%) observed in patients with R1 resection who received adjuvant radiotherapy.
- High 10-year disease-free survival (85%) and disease-specific survival (100%).
Conclusions:
- Wide surgical resection is highly effective for DFSP and DFSP-FS.
- Combining R1 resection with adjuvant radiotherapy significantly reduces local recurrence risk.
- Surgical management provides excellent long-term outcomes for DFSP.
