Annals of Surgical Oncology

, Volume 7, Issue 9, pp 696–704 | Cite as

Dermatofibrosarcoma Protuberans of the Head and Neck

  • Alexander Stojadinovic
  • Howard M. Karpoff
  • Cristina R. Antonescu
  • Jatin P. Shah
  • Bhuvanesh Singh
  • Ronald H. Spiro
  • Wilson Dumornay
  • Ashok R. Shaha
Original Article

Abstract

Background: Dermatofibrosarcoma protuberans (DFSP) of the head and neck is a rare, locally infiltrative, low-grade sarcoma. This study defines the clinical behavior of DFSP, evaluates the role of frozen section analysis, and identifies factors that predict local control.

Methods: Hospital records and pathological slides were reviewed for 33 patients with pathologically confirmed head and neck DFSP treated at Memorial Sloan-Kettering Cancer Center between 1964 and 1999. Factors were analyzed by using Fisher’s exact or (2 tests.

Results: For 21 primary and 12 recurrent patients, median age and tumor size at presentation was 39 years and 2.0cm, respectively. Thirty-two (97%) patients were alive at a median follow-up of 82 months. Three patients recurred locally, all with smaller than 2-cm resection margins. Deep tumors were more likely to have a margin-positive resection than superficial lesions (P = .03). Gross margin 2cm or more was a significant predictor of a negative histological margin (P < .001). There was a trend toward improved recurrence-free survival for tumors treated with wide (≥2 cm) margin resection (P = .059). Accuracy, sensitivity, specificity, and false negative rates of frozen section were 80%, 43%, 100%, and 57%, respectively.

Conclusions: Wide margin resection of head and neck DFSP predicts negative histological margins and impacts favorably on local recurrence-free survival. Frozen section analysis does not assess resection margins accurately.

Keywords

Dermatofibrosarcoma protuberans Head and neck Sarcoma 

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Copyright information

© The Society of Surgical Oncology, Inc. 2000

Authors and Affiliations

  • Alexander Stojadinovic
    • 1
  • Howard M. Karpoff
    • 1
  • Cristina R. Antonescu
    • 2
  • Jatin P. Shah
    • 1
  • Bhuvanesh Singh
    • 1
  • Ronald H. Spiro
    • 1
  • Wilson Dumornay
    • 1
  • Ashok R. Shaha
    • 1
    • 3
  1. 1.Head and Neck Service, Department of SurgeryMemorial Sloan-Kettering Cancer CenterNew York
  2. 2.Department of PathologyMemorial Sloan-Kettering Cancer CenterNew York
  3. 3.Head and Neck ServiceMemorial Sloan-Kettering Cancer CenterNew York

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