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Updated: Sep 28, 2025

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Dermatofibrosarcoma Protuberans Recurrence After Wide Local Excision Versus Mohs Micrographic Surgery: A Systematic

Emma C St Martin1, Krishna S Vyas2, Sarah Batbold1

  • 1Mayo Clinic Alix School of Medicine, Minnesota campus, Rochester, Minnesota.

Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [Et Al.]
|March 30, 2022
PubMed
Summary

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Dermatofibrosarcoma protuberans (DFSP) recurrence is lower with Mohs micrographic surgery (MMS) compared to wide local excision (WLE). MMS is recommended due to high rates of local recurrence (LR) after WLE for DFSP.

Area of Science:

  • Dermatology
  • Surgical Oncology
  • Oncology

Background:

  • Dermatofibrosarcoma protuberans (DFSP) is a rare skin cancer.
  • Local recurrence (LR) rates after surgical treatment for DFSP are not well-established.
  • Surgical modality may impact DFSP recurrence rates.

Purpose of the Study:

  • To compare the local recurrence (LR) rates of dermatofibrosarcoma protuberans (DFSP) treated with wide local excision (WLE) versus Mohs micrographic surgery (MMS).

Main Methods:

  • A systematic literature search was conducted across multiple databases (MEDLINE, Embase, Web of Science, Scopus).
  • Meta-analyses were performed on comparative (2-arm) and non-comparative (single-arm) studies.
  • Included studies focused on DFSP treated with either WLE or MMS.

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Main Results:

  • 88 studies met inclusion criteria, encompassing 12 comparative and 76 single-arm studies.
  • In comparative studies, LR rates were 1.7% for MMS (352 patients) and 3.7% for WLE (777 patients).
  • In single-arm studies, LR rates were 1.5% for MMS (980 patients) and 9.4% for WLE (2,215 patients).

Conclusions:

  • Mohs micrographic surgery (MMS) demonstrates a lower local recurrence (LR) rate for dermatofibrosarcoma protuberans (DFSP) compared to wide local excision (WLE).
  • Given the significant rates of postoperative DFSP LR, MMS should be strongly considered for treatment when available.