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Multidisciplinary surgical treatment approach for dermatofibrosarcoma protuberans: an update

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Abstract

Dermatofibrosarcoma protuberans (DFSP) is a cutaneous sarcoma that has remained a challenge for oncologic and reconstructive surgeons due to a high rate of local recurrence. The objective of this study is to investigate the oncologic and reconstructive benefits of employing a multidisciplinary two-step approach to the treatment of DFSP. A retrospective review was conducted using a prospectively collected database of all patients who underwent resection and reconstruction of large DFSPs by a multidisciplinary team, including a Mohs micrographic surgeon, surgical oncologist, dermatopathologist, and plastic and reconstructive surgeon, at one academic institution from 1998–2018. Each patient underwent Mohs micrographic surgery for peripheral margin clearance (Step 1) followed by wide local excision (WLE) of the deep margin by surgical oncology and immediate reconstruction by plastic surgery (Step 2). 57 patients met inclusion criteria. Average defect size after WLE (Step 2): 87.3 cm2 (range 8.5–1073.5 cm2). Mean follow-up time was 37 months (range 0–138 months). There were no cases of recurrence. A two-step multidisciplinary surgical treatment approach for DFSP minimizes risk of recurrence, decreases patient discomfort, and allows immediate reconstruction after deep margin clearance.

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Data availability

All data were collected from IRB approved retrospective chart review.

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Funding

No funding was provided in support of this work.

Author information

Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Department of Surgery, Northwestern Feinberg School of Medicine, Chicago, IL, USA

    Ava G. Chappell, Sydney C. Doe & John Y. S. Kim

  2. Department of Dermatology, Northwestern Feinberg School of Medicine, Arkes Pavilion, Suite 650, 676 N St Clair Street, Chicago, IL, 60611, USA

    Brandon Worley, Simon S. Yoo, Pedram Gerami, Murad Alam & Jeffrey D. Wayne

  3. Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University- St. Louis School of Medicine, St. Louis, MO, USA

    Donald W. Buck II

  4. Division of Surgical Oncology, Department of Surgery, Northwestern Feinberg School of Medicine, Chicago, IL, USA

    Jeffrey D. Wayne

Authors
  1. Ava G. Chappell
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  2. Sydney C. Doe
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  3. Brandon Worley
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  4. Simon S. Yoo
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  6. Murad Alam
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  7. Donald W. Buck II
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  8. John Y. S. Kim
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  9. Jeffrey D. Wayne
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Contributions

All authors had access to the information and certify its accuracy. Wayne, Chappell, Buck, Kim, Alam, Yoo, Gerami: intellectual design of study. Wayne, Chappell, Doe: Data Collection. Wayne, Chappell, Doe, Kim: Data Analysis. Chappell, Worley, Alam: drafting of the manuscript. All authors: revision of the manuscript for important intellectual content. All authors: final approval of the manuscript for submission.

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Correspondence to Jeffrey D. Wayne.

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Statement of Prior Presentation

Plastic Surgery the Meeting (ASPS) 2019 in San Diego, CA.

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Chappell, A.G., Doe, S.C., Worley, B. et al. Multidisciplinary surgical treatment approach for dermatofibrosarcoma protuberans: an update. Arch Dermatol Res 313, 367–372 (2021). https://doi.org/10.1007/s00403-020-02124-8

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  • DOI: https://doi.org/10.1007/s00403-020-02124-8

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