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Updated: May 20, 2026

A Mouse Model of Incompletely Resected Soft Tissue Sarcoma for Testing (Neo)adjuvant Therapies
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Systematic Review Comparing Wide Local Excision and Mohs Micrographic Surgery for Pleomorphic Dermal Sarcoma.

Jason Sivieng1, Ahmed Abid2, Ali Abid1,2,3

  • 1Department of Plastic and Reconstructive Surgery, Liverpool Hospital, Sydney, New South Wales, Australia.

ANZ Journal of Surgery
|May 19, 2026
PubMed
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This summary is machine-generated.

This review compared wide local excision (WLE) and Mohs micrographic surgery (MMS) for pleomorphic dermal sarcoma (PDS). Current evidence suggests complete excision is key, but MMS is not yet proven superior to WLE for PDS.

Area of Science:

  • Dermatology
  • Surgical Oncology
  • Cutaneous Malignancies

Background:

  • Pleomorphic dermal sarcoma (PDS) is a rare, aggressive skin cancer with metastatic potential.
  • Optimal surgical treatment for PDS, including wide local excision (WLE) and Mohs micrographic surgery (MMS), is not well-established.

Purpose of the Study:

  • To systematically review and compare oncological outcomes of WLE versus MMS for PDS management.
  • To evaluate recurrence and survival rates following different surgical modalities for PDS.

Main Methods:

  • A systematic literature search was performed across multiple databases up to December 2025.
  • Included studies reported histologically confirmed PDS treated with WLE and/or MMS, with recurrence and/or survival data.
  • Methodological quality was assessed using Joanna Briggs Institute tools.
Keywords:
Mohs micrographic surgerycomplete circumferential peripheral and deep margin assessmentmalignant fibrous histiocytomapleomorphic dermal sarcomaundifferentiated pleomorphic sarcomawide local excision

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Main Results:

  • Thirteen retrospective studies involving 543 patients were analyzed.
  • PDS primarily affects elderly individuals, often on the head and neck (scalp).
  • Wide local excision (WLE) showed variable local recurrence rates (4.2%–69%), influenced by completeness of excision and disease characteristics. Mohs micrographic surgery (MMS) data were limited by small sample sizes and confounding factors, with reported recurrence rates of 12.5%–20.9%. Metastatic rates were up to 19%, and disease-specific mortality was uncommon.

Conclusions:

  • Complete surgical excision with clear margins is essential for managing PDS.
  • While MMS may be suitable for specific cases, particularly in challenging anatomical locations, current evidence does not support its routine use over WLE.
  • Further multicenter research is needed to establish optimal surgical strategies for PDS.