title: Neoadjuvant imatinib therapy for dermatofibrosarcoma protuberans.
abstract: BACKGROUND
  Dermatofibrosarcoma protuberans (DFSP) is an unusual soft-tissue tumor with a propensity for subclinical extension and local recurrence. Surgical excision, even with tissue-sparing techniques, may cause significant deformity or disability because of the infiltrative nature of DFSP. In this study, we evaluate retrospective data obtained from 4 patients with locally advanced or recurrent DFSP who received neoadjuvant imatinib mesylate therapy before undergoing Mohs micrographic surgery.
  
  
  METHODS
  Patients treated with neoadjuvant imatinib therapy had an average tumor size reduction of 36.9%. This clinical response was paralleled by histopathologic changes, including decreased cellularity in 100% of the total area as well as significant hyalinization. Imatinib therapy for DFSP before Mohs micrographic surgery was associated with 100% local control at a maximum follow-up of 4 years.
  
  
  CONCLUSIONS
  Neoadjuvant imatinib therapy is a well-tolerated, novel approach to DFSP that reduces tumor burden and facilitates resection. Larger prospective studies are needed to confirm and expand on these results.
authors.affiliation: Department of Dermatology, Mount Sinai School of Medicine, New York, New York, USA. dr.annehan@gmail.com
authors.forename: Anne
authors.initials: A
authors.lastname: Han
authors.forename: Elbert H
authors.initials: EH
authors.lastname: Chen
authors.forename: George
authors.initials: G
authors.lastname: Niedt
authors.forename: William
authors.initials: W
authors.lastname: Sherman
authors.forename: Désirée
authors.initials: D
authors.lastname: Ratner
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D018223:Dermatofibrosarcoma / Q000188:drug therapy*; D006801:Humans; D000068877:Imatinib Mesylate; D020360:Neoadjuvant Therapy; D010879:Piperazines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate