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Effect of resection margins on dermatofibrosarcoma protuberans of the head and neck
S M Gayner1, J E Lewis, T V McCaffrey
1Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minn, USA.
Objective:
To determine clinical and surgical factors that affect the recurrence of dermatofibrosarcoma protuberans of the head and neck.
Design:
Retrospective case series of 32 patients who were seen between 1960 and 1995 with a diagnosis of dermatofibrosarcoma protuberans of the head and neck. Data extracted from patients records included sex, age at diagnosis, tumor site, presence or absence of tumor-free margins, initial and salvage treatment, time to recurrence, and status after last treatment.
Setting:
Academic tertiary care referral center.
Intervention:
Surgical excision and radiation therapy.
Results:
Univariate Kaplan-Meier analysis for recurrence showed the difference in survival to be statistically significant (P < .05) between patients who had wide (> or = 2 cm) surgical margins vs those who had close (< 2 cm) margins. Univariate Kaplan-Meier analysis for recurrence with or without radiation as the grouping variable showed the difference to be statistically significant (P < .01). Similar analyses with sex, age, tumor site, and size of tumor as the grouping variables were not statistically significant. Multivariate Cox regression analysis was used with sex, age, and close or wide margins as variables. Close margins (< 2 cm) had a statistically significant positive correlation with recurrence (P < .05), while sex and age were not associated with recurrence.
Conclusion:
Surgical margins of at least 2 cm should be used in all cases of dermatofibrosarcoma protuberans of the head and neck to prevent recurrence.