Ørholt Mathias, Abebe Kiya, Rasmussen Louise E, Aaberg Frederik L, Lindskov Lærke J, Schmidt Grethe, Wagenblast Anne Lene, Petersen Michael M, Loya Anand C, Daugaard Søren, Herly Mikkel, Jensen David Hebbelstrup, Vester-Glowinski Peter
Department of Plastic Surgery and Burns Treatment, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Department of Plastic Surgery and Burns Treatment, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
J Am Acad Dermatol. 2023 Dec;89(6):1177-1184. doi: 10.1016/j.jaad.2023.08.050. Epub 2023 Aug 25.
The prognosis of patients with atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS) remains uncertain and no standardized follow-up programs have been established.
To recommend a standardized follow-up program of patients with AFX and PDS based on nationwide long-term estimates of local recurrence and metastasis.
All patients with AFX and PDS in Denmark between 2002 and 2022 were included. Danish National Registries were used to estimate the risks of local recurrence and metastasis for AFX and PDS.
The 5-year risk of local recurrence was 10% for AFX and 17% for PDS. The 5-year risk of metastasis was 0.8% for AFX and 16% for PDS. PDS metastasized within 3 years in >90% of the patients with the lungs as the primary metastasis site (50%). Invasion beyond the subcutis, perineural/intravascular infiltration, and increasing age significantly increased the risk of PDS relapse.
Risk of misclassification and lack of detailed surgical information.
The follow-up of patients with AFX can be limited to clinical visits for 4 years. Patients with PDS should be followed with clinical visits and PET/CT twice a year for the first 3 years and once a year for a minimum of 1 year.
非典型纤维黄色瘤（AFX）和多形性皮肤肉瘤（PDS）患者的预后仍不确定，尚未建立标准化的随访方案。
基于全国范围内对局部复发和转移的长期评估，推荐AFX和PDS患者的标准化随访方案。
纳入2002年至2022年丹麦所有AFX和PDS患者。利用丹麦国家登记处评估AFX和PDS的局部复发和转移风险。
AFX的5年局部复发风险为10%，PDS为17%。AFX的5年转移风险为0.8%，PDS为16%。超过90%的PDS患者在3年内发生转移，主要转移部位为肺（50%）。皮下组织外侵犯、神经周/血管内浸润以及年龄增加显著增加PDS复发风险。
存在分类错误风险且缺乏详细手术信息。
AFX患者的随访可限于4年的临床就诊。PDS患者应在最初3年每年进行2次临床就诊和PET/CT检查，之后每年至少进行1次检查，持续1年。
