Effect Of Local Resection Upon Recurrence Of Dermatofibrosarcoma Protuberans

Objective:To investigate the effects of local operations on the recurrence of dermatofibrosarcoma protuberans(DFSP).Methods:The 37 inpatients with DFSP were collected during the period from 1999,11 to 2009,11 in 2nd affiliated hospital, Zhejiang University School of Medicine. The patients were divided into the local tumor excision and extensive tumor resection based on 2cm as the standard surgical margins. After the first surgical treatment,5 cases lost follow-up and 5 cases recommended to receive local radiotherapy. Surgical margin of 2 cases was unclear. The remaining 25 cases had follow-up and surgical margin records without postoperative radiotherapy. All 25 cases were followed up to Feb.2010.Result:Preoperative misdiagnosis was common, which led to higher tumor recurrence rate because of improper operation. Among the 25 cases,15 cases received local tumor excision and 10 cases received extensive tumor resection.10 cases developed local recurrence after local tumor resection and one case developed local recurrence after extensive resection. Tumor recurrence rates between the two groups were statistically significant (P=0.01). For the recurrent 11 cases,9 patients were followed up, two patients of recurrence lost after treatment. There was 1 special patient who relapsed 3 times after each operation. The previous two times of recurrence were after local tumor resections. The 3rd recurrence was received extensive tumor resection, there was no recurrence till now. In the remaining 8 follow-up recurrence cases,3 patients had received extensive tumor resection, no recurrence observed up to now. Other 5 follow-up recurrence cases received local tumor resection,1 patient still developed local recurrence after surgery. All 23 available recurrent cases were followed up for 3-119 months (median time was 46 months). Recurrence occurred during 1 month to 10 years after surgery. Median recurrence time was 6 months.Conclusions:Surgical margin was an important factor for predicting DFPS recurrence. Extensive tumor resection had better local control rate and was strongly recommended.