Kim Byung Jun, Kim Hyeonwoo, Jin Ung Sik, Minn Kyung Won, Chang Hak
Department of Plastic Surgery, College of Medicine, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea.
Biomed Res Int. 2015;2015:642549. doi: 10.1155/2015/642549. Epub 2015 Nov 25.
Dermatofibrosarcoma protuberans (DFSP), a rare low-grade sarcoma of fibroblast origin, tends to extend in a finger-like fashion beyond macroscopic tumor margins. Therefore, incomplete removal and subsequent recurrence are common. This study aimed to determine the efficacy of wide local excision (WLE) for controlling local recurrence of DFSP.
The medical records of 90 DFSP patients who received WLE at our hospital between June 1992 and January 2015 were retrospectively reviewed. WLE was conducted including a 3 cm (range, 1 to 5 cm) safety margin according to tumor size, location, and recurrence status. Clinical and tumor characteristics and surgical methods were evaluated for risk factor analysis and local recurrence-free survival.
DFSP occurred most often in patients in their 30s (30%) and on the trunk (51.1%). Five patients (5.5%) experienced local recurrence during the 43.4-month follow-up period. Recurrence was found at a mean of 10.8 months after WLE. Although no factors were significantly associated with recurrence, recurrences were more frequent in head and neck. Recurrence-free survival was 87% in 6 years and 77% in 7 years.
WLE with adequate lateral and deep margins can effectively control local recurrence rate and is a simple and effective method to treat DFSP.
隆突性皮肤纤维肉瘤(DFSP)是一种罕见的起源于成纤维细胞的低度恶性肉瘤,往往呈指状延伸至肉眼可见的肿瘤边缘之外。因此,切除不彻底及随后的复发很常见。本研究旨在确定广泛局部切除(WLE)控制DFSP局部复发的疗效。
回顾性分析1992年6月至2015年1月在我院接受WLE的90例DFSP患者的病历。根据肿瘤大小、位置和复发情况,进行WLE时包括3厘米(范围1至5厘米)的安全切缘。评估临床和肿瘤特征及手术方法以进行危险因素分析和局部无复发生存率分析。
DFSP最常发生于30多岁的患者(30%),且多见于躯干(51.1%)。在43.4个月的随访期内,5例患者(5.5%)出现局部复发。复发平均发生在WLE后10.8个月。虽然没有因素与复发显著相关,但头颈部复发更频繁。6年无复发生存率为87%,7年为77%。
具有足够侧向和深部切缘的WLE可有效控制局部复发率,是治疗DFSP的一种简单有效的方法。