Multidisciplinary surgical treatment approach for dermatofibrosarcoma protuberans: an update

Ava G. Chappell, Sydney C. Doe, Brandon Worley, Simon S. Yoo, Pedram Gerami, Murad Alam, Donald W. Buck, John Yah Sung Kim, Jeffrey D. Wayne*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

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 cm2 (range 8.5–1073.5 cm2). 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.

Original languageEnglish (US)
JournalArchives of Dermatological Research
DOIs
StateAccepted/In press - 2020

Keywords

  • Dermatofibrosarcoma protuberans
  • Mohs surgery
  • Multidisciplinary care
  • Reconstructive surgery
  • Wide local excision

ASJC Scopus subject areas

  • Dermatology

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