Chang C K, Jacobs I A, Salti G I
Department of Surgery, Naples Community Hospital, Naples, FL, USA.
Eur J Surg Oncol. 2004 Apr;30(3):341-5. doi: 10.1016/j.ejso.2003.12.005.
Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue sarcoma usually presenting as nodular cutaneous mass on the trunk and proximal extremity. The tumour grows slowly, typically over years. The standard treatment is wide local excision with at least a 3-cm margin. The local regional recurrence is up to 50%, emphasizing the need for wide margins for local control. A small fraction of DFSP may metastasize, but on histological examination such tumours have features of fibrosarcomas rather than DFSP.
This study was done to review our experience of the time interval to recurrence of DFSP.
A retrospective review was undertaken to identify patients with DFSP in our university teaching hospital.
All patients received their primary surgical treatment in our department between February 1968 and June 2001. Treatment consisted of wide local excision with margins of at least 3 cm. The chi-square test and Fisher's exact test were performed to determine the relationship between recurrence and clinicopathological variables. We evaluated the prognostic variables using the Kaplan-Meier method with log-rank comparison.
The median follow-up period was 59 months. The 5 and 10-year disease-free survival (DFS) were 86 and 76%, respectively. The overall recurrence rate was 16.7%. The mean time to recurrence was 38+/-12 months (range 1-100 months). In 30% of those patients with recurrences, the local regional recurrence was after 5 years.
Wide local excision with good margins decreases local regional recurrences in patients with DFSP. Close surveillance is necessary even beyond 5 years because late recurrences occur.
隆突性皮肤纤维肉瘤（DFSP）是一种罕见的软组织肉瘤，通常表现为躯干和近端肢体上的结节状皮肤肿物。肿瘤生长缓慢，通常持续数年。标准治疗方法是进行至少3厘米切缘的广泛局部切除。局部区域复发率高达50%，这凸显了为实现局部控制而进行广泛切缘的必要性。一小部分DFSP可能会发生转移，但经组织学检查，这类肿瘤具有纤维肉瘤的特征而非DFSP的特征。
本研究旨在回顾我们关于DFSP复发时间间隔的经验。
进行了一项回顾性研究，以确定我们大学教学医院中患有DFSP的患者。
所有患者于1968年2月至2001年6月在我们科室接受了初次手术治疗。治疗包括至少3厘米切缘的广泛局部切除。采用卡方检验和Fisher精确检验来确定复发与临床病理变量之间的关系。我们使用Kaplan-Meier方法和对数秩检验来评估预后变量。
中位随访期为59个月。5年和10年无病生存率（DFS）分别为86%和76%。总复发率为16.7%。复发的平均时间为38±12个月（范围为1 - 100个月）。在那些复发的患者中，30%的局部区域复发发生在5年后。
具有良好切缘的广泛局部切除可降低DFSP患者的局部区域复发率。即使超过5年也有必要进行密切监测，因为会发生晚期复发。
