Time to recurrence after surgical excision of atypical fibroxanthoma-updated systematic review and meta-analysis

Atypical fibroxanthoma (AFX) remains a rare cutaneous dermally based fibrohistiocytic tumour with high rates of local recurrence. Mohs micrographic surgery (MMS) and wide local excision (WLE) with margins 1-2 cm are two surgical options. It is unclear whether timing of recurrence following surgical excision of AFX differs according to technique. A systematic review and meta-analysis were performed according to PRISMA guidelines. There was a total of 188 MMS cases and 783 WLE cases. The pooled proportion of MMS cases of recurrence is 6.6% (95% CI 3.6-11.9%), compared with WLE 11.3% (95% CI 7.1-16.5%), which was not significantly different (P = 0.12) Pooled time to recurrence of MMS for AFX to be 14.2 (95% CI 11.6-16.8%) months, compared to 13.3 (95% CI 9.99-16.6%) months (P = 0.86). Our findings suggest that recurrence rates are similar between MMS and WLE techniques and that timing of recurrence is similar regardless of surgical technique employed.