Multidisciplinary surgical treatment approach for dermatofibrosarcoma protuberans: an update

Dermatofibrosarcoma protuberans (DFSP) is a cutaneous sarcoma that has remained a challenge for oncologic and reconstructive surgeons due to a high rate of local recurrence. The objective of this study is to investigate the oncologic and reconstructive benefits of employing a multidisciplinary two-s...

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Bibliographic Details
Published in:Archives of Dermatological Research 2021-07, Vol.313 (5), p.367-372
Main Authors: Chappell, Ava G., Doe, Sydney C., Worley, Brandon, Yoo, Simon S., Gerami, Pedram, Alam, Murad, Buck, Donald W., Kim, John Y. S., Wayne, Jeffrey D.
Format: Article
Language:English
Subjects:
Cancer surgery
Dermatofibrosarcoma protuberans
Dermatology
Medicine
Medicine & Public Health
Micrography
Multidisciplinary teams
Oncology
Original Paper
Patients
Reconstructive surgery
Sarcoma
Skin cancer
Surgeons
Surgery
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Summary:Dermatofibrosarcoma protuberans (DFSP) is a cutaneous sarcoma that has remained a challenge for oncologic and reconstructive surgeons due to a high rate of local recurrence. The objective of this study is to investigate the oncologic and reconstructive benefits of employing a multidisciplinary two-step approach to the treatment of DFSP. A retrospective review was conducted using a prospectively collected database of all patients who underwent resection and reconstruction of large DFSPs by a multidisciplinary team, including a Mohs micrographic surgeon, surgical oncologist, dermatopathologist, and plastic and reconstructive surgeon, at one academic institution from 1998–2018. Each patient underwent Mohs micrographic surgery for peripheral margin clearance (Step 1) followed by wide local excision (WLE) of the deep margin by surgical oncology and immediate reconstruction by plastic surgery (Step 2). 57 patients met inclusion criteria. Average defect size after WLE (Step 2): 87.3 cm 2 (range 8.5–1073.5 cm 2 ). Mean follow-up time was 37 months (range 0–138 months). There were no cases of recurrence. A two-step multidisciplinary surgical treatment approach for DFSP minimizes risk of recurrence, decreases patient discomfort, and allows immediate reconstruction after deep margin clearance.
ISSN:0340-3696
1432-069X
DOI:10.1007/s00403-020-02124-8