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To Mohs or not to Mohs.
Constantinos Kokkinos1, Tracy Sorkin1, Barry Powell1
1Plastic and Reconstructive Surgery Department, St George's Hospital, Tooting, London, UK.
Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|October 9, 2013
Summary
Wide local excision (WLE) for Dermatofibrosarcoma Protuberance (DFSP) achieves clear margins and no recurrence in a single procedure. This single-stage approach offers an effective alternative to multi-stage Mohs surgery for DFSP treatment.
Area of Science:
- Dermatologic Surgery
- Surgical Oncology
- Cutaneous Malignancies
Background:
- Dermatofibrosarcoma Protuberance (DFSP) is a rare skin cancer.
- Surgical excision is the primary treatment for DFSP.
- Current surgical options like Mohs surgery often require multiple procedures.
Purpose of the Study:
- To evaluate the efficacy of Wide Local Excision (WLE) for DFSP.
- To assess WLE's ability to achieve clear histopathological margins in a single procedure.
- To determine the recurrence rate of DFSP treated with WLE.
Main Methods:
- Retrospective analysis of 20 DFSP cases treated between 2002 and 2012.
- All patients underwent WLE by a single surgeon.
- Data on excision margins, complications, and recurrence were analyzed.
Main Results:
- No incomplete excisions or tumor recurrences were recorded.
- Mean peripheral margin was 17 mm, and deep margin was 9 mm.
- Excision and reconstruction were completed in a single day for all patients, with no postoperative complications.
Conclusions:
- Wide Local Excision (WLE) is an effective single-stage treatment for DFSP.
- WLE achieves clear margins and low recurrence rates, comparable to multi-stage procedures.
- This approach simplifies treatment and reconstruction planning for DFSP.
