Surgical Management of Dermatofibrosarcoma Protuberans: A Siriraj Experience
Sorawuth ChuOngsakul MD, MHA*, Satawat Piyakulvorawat MD*
Affiliation : * Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Dermatofibrosarcoma protuberans (DFSP) presents as an asymptomatic, firm, raised dermal nodule or
plaque and interdigitating to surrounding tissue. That made DFSP easily inadequate resection and locally recurred. Wide
excision with margins greater than 2 cm was recommended to reduce recurrence rates. Predictors for recurrence were tumor
depth (Hazard ratio 3.14) and negative margin (Hazard ratio 22.43).
Objective : The aim of this study was to define proper margin width to achieve negative resection margin.
Material and Method: Patients with DFSP received wide excision at Siriraj Hospital were retrospectively reviewed between
January 2008 and March 2014. Demographic data, operative records and pathologic reports were recorded, relation of
resection margin and pathologic outcome were evaluated.
Results : Fifty-nine patients’ data were collected. Patients’ genders were equal. Tumors presented in head and neck region in
19 patients (32%), trunk in 26 patients (44%). The total free margin status was found in 46 patients (78%), positive margin
status was found in 7 patients (12%). The median follow-up duration was 32.6 months. Two patients had recurrence.
Significant difference occurs when comparing the group with margin at 1.5 cm or more and group with margin less than 1.5
cm.
Conclusion : The authors’ recommended wide resection margins of 1.5 cm or more to achieve negative resection margin
results.
Keywords : Dermatofibrosarcoma protuberans, Surgical management, Dermatofibrosarcoma protuberans, DFSP, Wide excision, Margin, Positive margin, Head and neck, Pregnancy
