Multidisciplinary surgical treatment approach for dermatofibrosarcoma protuberans: an update

Area of Science:

• Oncology
• Dermatology
• Plastic Surgery

Background:

• Dermatofibrosarcoma protuberans (DFSP) presents a significant challenge for surgeons due to its high local recurrence rate.
• Effective treatment strategies are crucial for managing this rare cutaneous sarcoma.

Purpose of the Study:

• To evaluate the oncologic and reconstructive outcomes of a multidisciplinary, two-step surgical approach for treating DFSP.
• To assess the efficacy of combining Mohs micrographic surgery with wide local excision and immediate reconstruction.

Main Methods:

• A retrospective review of 57 patients with large DFSPs treated between 1998 and 2018.
• A two-step approach involving Mohs surgery for peripheral margin clearance followed by wide local excision of the deep margin and immediate reconstruction.
• Involvement of a multidisciplinary team including Mohs surgeons, surgical oncologists, dermatopathologists, and plastic surgeons.

Main Results:

• No cases of recurrence were observed during a mean follow-up of 37 months.
• The average defect size after wide local excision was 87.3 cm².
• The approach facilitated immediate reconstruction following deep margin clearance.

Conclusions:

• The multidisciplinary two-step surgical approach for DFSP effectively minimizes the risk of recurrence.
• This treatment strategy enhances patient comfort and allows for timely reconstruction.
• This combined approach offers significant oncologic and reconstructive benefits for DFSP management.