title: Surgical treatment for dermatofibrosarcoma protuberans: the Dartmouth experience and literature review.
abstract: BACKGROUND
  Dermatofibrosarcoma protuberans (DFSP) is an invasive soft tissue tumor with asymmetric pattern of growth and propensity for recurrences, thus warranting systematic treatment planning at onset. We conducted a retrospective analysis of 25 patients with DFSP that received either wide excision, modified wide excision (with horizontal processing), Mohs micrographic surgery (MMS), or combination surgery. Follow-up ranged from 15-133 months, with a median of 68 months.
  
  
  CONCLUSIONS
  Fourteen patients were treated with wide excision, 4 with modified wide excision, 6 with MMS followed by modified wide excision, and 1 with MMS. No recurrences were reported. Patients with lesions arising from "cosmetically sensitive" areas (head and neck) most often underwent MMS or modified wide excision. Our study supports that all 4 surgical treatment methods were successful in achieving recurrence-free survival, but emphasis on presurgical planning and patient selection for each surgical approach is key to allow for the least complicated repair while maximizing tissue preservation.
authors.affiliation: Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon NH 03756, USA. wenshu.yu@hitchcock.org
authors.forename: Wenshu
authors.initials: W
authors.lastname: Yu
authors.forename: Maria M
authors.initials: MM
authors.lastname: Tsoukas
authors.forename: Shane M
authors.initials: SM
authors.lastname: Chapman
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Rosen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D018223:Dermatofibrosarcoma / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000379:methods*; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*