A single-institutional review of 68 patients with dermatofibrosarcoma protuberans
- \(\textbf {Background:}\) Dermatofibrosarcoma protuberans (DFSP) is a cutaneous soft tissue sarcoma characterized by an indolent but aggressive local growth. Unplanned excisions with positive margins are common, and the prognostic impact of radical re-excisions is still unclear. The aim of the present study was to identify prognostic indicators of recurrence-free survival (RFS) in patients with DFSP through a long-term follow-up. We tried particularly to determine the prognostic impact of surgical margins and re-excisions in patients after earlier inadequate surgery. \(\textbf {Methods:}\) Seventy-five patients with DFSP were treated surgically at our institution between 1999 and 2015. Analyses were restricted to 68 participants with available information on surgical margins. The median follow-up was 5.4 years. \(\textbf {Results:}\) Fifty-four patients (79.4%) had low-grade DFSP and 14 patients (20.6%) intermediate-grade FS-DFSP. The 5-year RFS rates were estimated to be 93.5% (95% CI 81.2–97.9) for low-grade DFSP and 39.7% (95% CI 13.0–65.8) for FS-DFSP (\(\it P\) < 0.0001). Re-excisions were performed in 55 patients (80.9%) following R1 or marginal R0 resections. Negative margins could be attained in a total of 65 patients (95.6%). Negative margin widths >1 cm led to the best local outcome within the R0 subgroup. Significant adverse prognostic features in the multivariate analysis included histologic grade and close margins. \(\textbf {Conclusions:}\) The data from this study underscore the long-term benefit of negative margins. In our analysis, re-excisions were an effective method to achieve a high rate of local control in patients who presented after R1 or marginal R0 resection. To ensure the best outcome, re-excisions should aim at negative margin widths of more than 1 cm in the histologic specimen.
Author: | Kamran HaratiGND, Kim LangeGND, Ole GoertzGND, Armin LahmerGND, Roman Nicolai KapalschinskiGND, Ingo StrickerGND, Marcus LehnhardtGND, Adrien DaigelerORCiDGND |
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URN: | urn:nbn:de:hbz:294-58602 |
DOI: | https://doi.org/10.1186/s12957-016-1075-2 |
Parent Title (English): | World journal of surgical oncology |
Subtitle (English): | wide re-excision after inadequate previous surgery results in a high rate of local control |
Document Type: | Article |
Language: | English |
Date of Publication (online): | 2018/07/05 |
Date of first Publication: | 2017/01/05 |
Publishing Institution: | Ruhr-Universität Bochum, Universitätsbibliothek |
Tag: | Open Access Fonds Dermatofibrosarcoma; Excision; Margin; Recurrence; Survival |
Volume: | 15 |
Issue: | 1 |
First Page: | 5-1 |
Last Page: | 5-9 |
Note: | Article Processing Charge funded by the Deutsche Forschungsgemeinschaft (DFG) and the Open Access Publication Fund of Ruhr-Universität Bochum. |
Institutes/Facilities: | Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Klinik für Plastische Chirurgie und Schwerbrandverletzte, Handchirurgie-Zentrum |
Dewey Decimal Classification: | Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit |
open_access (DINI-Set): | open_access |
faculties: | Medizinische Fakultät |
Licence (English): | Creative Commons - CC BY 4.0 - Attribution 4.0 International |