title: Dermatofibrosarcoma protuberans: review of 20-years experience.
abstract: BACKGROUND
  Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue neoplasm with low-intermediate grade of malignancy. It is a locally aggressive tumour with a high recurrence rate. Surgical excision with adequate margins is the main treatment.
  
  
  METHODS
  We describe the clinicopathological features of 21 cases of DFSP. The mean size of the lesions was 5.6 cm, mostly located in trunk. 61.9% of the cases underwent surgical excision without previous biopsy. 52.4% of the patients presented positive margins, that required surgical extension.
  
  
  RESULTS
  The recurrence rate was 28.6% (6 cases), five of them local recurrences treated with new surgical excision with wide margins. Median period free of illness was 32.5 months. Medium follow-up period was 33.25 months.
  
  
  CONCLUSIONS
  DFSP has a locally high recurrence rate, that has been associated to inadequate surgical margins. The histological knowledge preoperatively would permit surgical excision with adequate margins, and probably this could reduce the recurrence rate. Radiotherapy could avoid the surgical extension of margins in these cases with positive ones. Chemotherapy could be indicated in metastasic cases. Most recurrences appear in the first 3 years, but it is important a long-term follow-up of these patients.
authors.affiliation: Department of Surgery, University Hospital Ramón y Cajal, Madrid, Spain. jruiztovar@gmail.com
authors.forename: Jaime
authors.initials: J
authors.lastname: Ruiz-Tovar
authors.forename: Montserrat
authors.initials: M
authors.lastname: Fernández Guarino
authors.forename: María Eugenia
authors.initials: ME
authors.lastname: Reguero Callejas
authors.forename: Asunción
authors.initials: A
authors.lastname: Aguilera Velardo
authors.forename: Juan
authors.initials: J
authors.lastname: Arano Bermejo
authors.forename: Luis
authors.initials: L
authors.lastname: Cabañas Navarro
mesh_terms: D000328:Adult; D018223:Dermatofibrosarcoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*