Long-term outcomes of surgical treatment for dermatofibrosarcoma protuberans according to width of gross resection margin

Kyong Je Woo, Sa Ik Bang, Goo Hyun Mun, Kap Sung Oh, Jai Kyong Pyon, So Young Lim

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Background Controversy exists regarding appropriate surgical treatment for dermatofibrosarcoma protuberans (DFSP). The purpose of this study was to propose treatment recommendations based on long-term outcomes of surgical treatments for DFSP. Methods A total of 63 patients who underwent surgical resection for primary DFSP were retrospectively reviewed from 1999 to 2011. They were classified into three groups based on the width of the gross resection margins: group I with marginal excision (14 patients); group II with resection margins < 3 cm (21 patients); and group III with resection margins ≥ 3 cm (28 patients) (group II and group III had wide local excision). Results The median follow-up period was 65 months (range 31-190 months). The marginal excision group showed a significantly higher recurrence rate than the wide excision group (35.7% vs. 0%, p < 0.001). Among wide excision groups, group III showed a significantly higher requirement for reconstructive surgery than group II (82.7% vs. 52.4%, p = 0.011), yet both groups had no recurrence and pathologic margin status was comparable. The accuracy rate of frozen section analyses was 100% for the margin status in the wide excision group. Adjuvant radiation was significantly associated with a reduced recurrence in the marginal excision group (0% vs. 60%, p = 0.016). Conclusions Wide local excision with margins of 1.5-2 cm along with frozen biopsy is recommended for DFSP. Either re-excision or adjuvant radiation therapy can serve as a treatment option for patients with positive margins.

Original languageEnglish
Pages (from-to)395-401
Number of pages7
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Volume69
Issue number3
DOIs
StatePublished - 1 Mar 2016

Keywords

  • Adjuvant radiation
  • Frozen biopsy
  • Gross resection margin
  • Local recurrence
  • Surgical treatment
  • Wide local excision

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