title: Mohs micrographic surgery for dermatofibrosarcoma protuberans (DFSP): a single-centre series of 76 patients treated by frozen-section Mohs micrographic surgery with a review of the literature.
abstract: Dermatofibrosarcoma protuberans (DFSP) is a rare low-grade sarcoma that typically presents with local invasion but rarely metastasises. Surgical excision remains the first-line treatment for DFSP. There are no randomised controlled or prospective studies comparing wide local excision (WLE) with Mohs micrographic surgery (MMS), but available evidence from the retrospective studies and case series available has consistently shown higher recurrence rates for standard surgery and WLE than for MMS. Combined recurrence rates of data within the last 20 years for WLE have been reported at 7.3% compared with 1.1% for MMS. Our aim was to review the clinical details and recurrence rates of DFSP cases treated with frozen-section MMS in our centre between 1996 and February 2013. The relevant data were collected from the case notes. It involved 76 patients with nine of these patients lost to follow-up. In the remaining 67 (67/76) cases, the recurrence rate was 1.5% during the mean follow-up period of 50 months (2-132). This is comparable to recurrence rates for the MMS in the literature [20,21]. Our series is the largest series for frozen-section MMS reported to date. Based on these findings and the current literature evidence, we advocate MMS as the treatment of choice for DFSP in all locations.
authors.affiliation: Department of Dermatology, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, UK. Electronic address: sloghdey@yahoo.com.
authors.forename: Mohamed Saleem
authors.initials: MS
authors.lastname: Loghdey
authors.affiliation: Department of Dermatology, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, UK.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Varma
authors.affiliation: Department of Dermatology, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, UK.
authors.forename: Sanjay M
authors.initials: SM
authors.lastname: Rajpara
authors.affiliation: Department of Dermatology, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, UK.
authors.forename: Haytham
authors.initials: H
authors.lastname: Al-Rawi
authors.affiliation: Department of Plastic Surgery, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, UK.
authors.forename: Graeme
authors.initials: G
authors.lastname: Perks
authors.affiliation: Department of Dermatology, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, UK.
authors.forename: William
authors.initials: W
authors.lastname: Perkins
mesh_terms: D018223:Dermatofibrosarcoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D015580:Mohs Surgery; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000379:methods; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: Cutaneous sarcoma; Dermatofibrosarcoma Protuberans; Mohs micrographic surgery; Wide local excision