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Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
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MRI-Based Surgical Margin Assessment in Dermatofibrosarcoma Protuberans: Correlation With Pathological Extent.

Munehisa Kito1, Mai Iwaya2, Toshikazu Omodaka3

  • 1Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.

The Journal of Dermatology
|July 4, 2026
PubMed
Summary
This summary is machine-generated.

Preoperative MRI aids surgical planning for dermatofibrosarcoma protuberans (DFSP). A 20mm lateral margin appears sufficient for complete tumor resection, with fascia assessment predicting deep invasion risk.

Keywords:
dermatofibrosarcoma protuberanslocal recurrencemagnetic resonance imagingsurgical marginwide local excision

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Area of Science:

  • Dermatologic Surgery
  • Oncology
  • Radiology

Background:

  • Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive skin cancer with high recurrence rates after incomplete excision.
  • Wide local excision (WLE) is common, but the role of preoperative imaging for margin assessment is unclear.

Purpose of the Study:

  • To evaluate the clinical utility of preoperative MRI in surgical margin assessment for DFSP treated with WLE.
  • To determine if MRI-based planning correlates with pathological margin status and guides resection adequacy.

Main Methods:

  • Retrospective analysis of 42 DFSP patients (including FS-DFSP) undergoing MRI-based surgical planning and WLE (2009-2023).
  • Lateral margins assessed via MRI, deep tumor extent evaluated based on fascial relationship.
  • Analysis included 36 patients with identifiable pathology; planned vs. pathological margins compared.

Main Results:

  • Median planned lateral margin was 20mm, median pathological margin was 16.5mm (planned margins significantly larger, p<0.001).
  • Weak correlation between planned and pathological margins (p=0.060); maximum underestimation of tumor extent was 18mm.
  • Fascia-contacting or beyond lesions on MRI had higher deep invasion likelihood (OR 27.0). Residual tumor found in 71% after unplanned excision.

Conclusions:

  • Preoperative MRI provides valuable information for DFSP surgical margin assessment.
  • A 20mm lateral margin seems adequate for complete resection; fascia assessment aids in predicting deep invasion risk.
  • All patients achieved R0 resection without recurrence; distant metastases only in FS-DFSP.