title: Dermatofibrosarcoma protuberans: recurrence is related to the adequacy of surgical margins.
abstract: BACKGROUND
  The aim of the study was to investigate the results of surgical treatment in primary and recurrent dermatofibrosarcoma protuberans (DFSP), with respect to local tumor control.
  
  
  METHODS
  Thirty-eight patients were treated between 1971 and 2005 at the University Medical Center Groningen (UMCG). Thirty patients presented with primary disease (79%) and 8 patients with locally recurrent disease (21%). The treatment consisted of surgical resection and in case of marginal or positive resection margins (R1 resection) adjuvant radiotherapy.
  
  
  RESULTS
  Adequate surgical margins as a single modality was associated with 100% local control in all primary DFSPs. Two patients whose resection specimens had microscopically positive resection margins had withdrawn from adjuvant radiotherapy and developed local recurrence (LF rate 7%). Two of the 8 patients referred with a local recurrence developed a second recurrence (LF rate 25%); one of these patients developed distant disease and ultimately died of systemic disease. None of the five patients with DFSP-FS developed LF after treatment at the UMCG. After a median follow-up of 89 (12-271) months, the 10-year disease-free survival was 85% and the 10-year disease specific survival was 100%.
  
  
  CONCLUSIONS
  After wide surgical resection of a DFSP or DFSP-FS, or an R1 resection combined with adjuvant radiotherapy the risk of local recurrence is extremely low.
authors: Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, P. O. Box 30.001, 9700 RB Groningen, The Netherlands.
authors: S Ten
authors: ST
authors: Heuvel
authors: A
authors: A
authors: Suurmeijer
authors: E
authors: E
authors: Pras
authors: R J
authors: RJ
authors: Van Ginkel
authors: H J
authors: HJ
authors: Hoekstra
mesh_terms: D000328:Adult; D002648:Child; D018223:Dermatofibrosarcoma / Q000532:radiotherapy / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D012878:Skin Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D055815:Young Adult