Reducing surgical margins in dermatofibrosarcoma protuberans using the pathological analysis technique ‘vertical modified technique’: A 5-year experience

Hersant, Barbara; P, May; Battistella, Maxime; Pagès, Cécile; Lebbe, Célèste; Revol, M.

doi:10.1016/j.bjps.2013.01.016

Cited by 11 publications

(10 citation statements)

References 20 publications

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“…8,10,[12][13][14][15][16][17][18] The median time to recurrence in previous studies ranged from 18.5 to 40.6 months 10,16,19-21 ; whereas, in our study, the median time to recurrence was 55.5 months. 8,10,[12][13][14][15][16][17][18] The median time to recurrence in previous studies ranged from 18.5 to 40.6 months 10,16,19-21 ; whereas, in our study, the median time to recurrence was 55.5 months.…”

Section: Discussioncontrasting

confidence: 77%

“…The risk factors for recurrences identified in the current study with multivariate analysis (FS change and R1 resection) are in line with previously published data. 8,10,[12][13][14][15][16][17][18] The median time to recurrence in previous studies ranged from 18.5 to 40.6 months 10,16,[19][20][21] ; whereas, in our study, the median time to recurrence was 55.5 months. This demonstrates that recurrences can occur even many years after the primary tumor, possibly leading to an underestimation of the median time to recurrence in studies with shorter follow-up.…”

Section: Discussioncontrasting

confidence: 72%

“…9,10,24 Criscito et al reported that survival was influenced by tumor size, but they did not analyze the relation between recurrence and size. 10,15,26 No metastases were identified in patients without FS changes in this series. 10,24 In the current study, only 4 patients (1.1%) developed distant metastases, indicating that larger DFSPs and those with FS changes are more likely to develop metastases versus smaller DFSPs and those without FS changes.…”

Section: Discussionmentioning

confidence: 51%

“…3,22,23 Only Fields and colleagues did not identify FS change as a factor that influenced recurrence. 3,10,15,25,26 Two reviews reported metastases rates of 13.4% and 14.4% in patients with FS changes and 1.1% in patients without FS changes. The prognostic value of tumor size also is debated in other reports.…”

Section: Discussionmentioning

confidence: 99%

“…The risk of metastases in patients who have DFSP with FS changes has been described previously, but series on this subject are scarce and consist of limited numbers of patients or case reports. 3,10,15,25,26 Two reviews reported metastases rates of 13.4% and 14.4% in patients with FS changes and 1.1% in patients without FS changes. 3,25 One of those reviews indicated that 83.4% of metastases were preceded by a recurrence.…”

Section: Discussionmentioning

confidence: 99%

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Outcome after surgical treatment of dermatofibrosarcoma protuberans: Is clinical follow‐up always indicated?

Veld

Coevorden

Grünhagen

et al. 2019

Cancer

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BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue sarcoma for which clinical examination up to 10 years is recommended. The objective of this study was to identify prognostic factors for recurrences and metastases that can be used to evaluate the validity of follow-up schedules after treatment for DFSP. METHODS: Patients with DFSP who received treatment between 1991 and 2016 at 3 tertiary centers were included. Cox regression analyses were conducted to identify variables associated with the primary endpoints. RESULTS: In total 357 patients were included, with a median age of 38 years (age range, 2-87 years) and a median follow-up of 60 months (interquartile range, 24-115 months). Eighty-one patients developed recurrent disease (22.7%), and the median time to recurrence was 55.5 months (interquartile range, 20-90 months). Of these, 50 tumors (61.7%) were identified by patient self-examination, whereas 3 recurrences (3.7%) were identified at clinical surveillance. For the remaining 28 tumors, no information was available on how the recurrences were identified (34.6%). Fibrosarcomatous change (hazard ratio, 21.865; P < .001), and positive resection margins (hazard ratio, 14.645; P < .001), were independent prognostic factors for recurrence. Metastases occurred in 4 patients (1.1%). All tumors were identified by imaging after patients presented with symptomatic metastases. Fibrosarcomatous change (P < .001) and tumor size >5 cm (P = .014) were associated with the development of metastases. CONCLUSIONS: Disease recurrence after resection of DFSP remains a significant issue, whereas metastases are uncommon. The majority of recurrences are identified by patient self-examination. Consideration should be given to individualized follow-up schedules based on risk factors for recurrences and metastases. Cancer 2019;125:735-741.

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