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Micrographic Surgery Allows Fascia Preservation in Dermatofibro-sarcoma Protuberans
Maximilian Gassenmaier1, Erik Weber, Ulrike Leiter
1Department of Dermatology, Eberhard Karls University of Tübingen, DE-72076 Tuebingen, Germany.
Acta Dermato-Venereologica
|September 7, 2021
Summary
Fascia preservation is feasible during micrographic surgery for dermatofibrosarcoma protuberans, especially for superficial tumors outside the head and neck. This approach is safe for most patients, reducing recurrence risk.
Area of Science:
- Dermatology
- Surgical Oncology
Background:
- Dermatofibrosarcoma protuberans (DFSP) treatment often involves deep fascia removal.
- The necessity of fascia removal in micrographic surgery for DFSP is not well-established.
Purpose of the Study:
- To evaluate the feasibility and safety of preserving deep fascia during micrographic surgery for DFSP.
- To identify risk factors for tumor extension beyond the subcutis in DFSP.
Main Methods:
- Retrospective clinicopathological analysis of 48 patients with DFSP treated by micrographic surgery.
- Assessment of tumor location relative to deep fascia (trunk, extremities, head, and neck).
Main Results:
- 93% of trunk/extremity tumors and 14% of head/neck tumors were superficial to the fascia.
- Head and neck location was the only significant risk factor for deep tumor extension (p<0.001).
- 44% of tumors were excised above fascia; 56% required deeper excision. Two head tumors recurred, both with fascia involvement.
Conclusions:
- Micrographic surgery enables fascia preservation in superficial DFSP, particularly on the trunk and extremities.
- Fascia preservation is a safe and feasible option for most DFSP cases treated with micrographic surgery, excluding those with deep infiltration, especially in the head and neck region.
