An Experience of Slow-Mohs Micrographic Surgery for the Treatment of Dermatofibrosarcoma Protuberans: A Long-Term Cohort Study Publisher Pubmed



Asilian A¹ ; Honarjou N² ; Faghihi G¹ ; Saber M¹ ; Mozafarpoor S³ ; Hafezi H³
Source: Journal of Cosmetic Dermatology Published:2020

Abstract

Background: Dermatofibrosarcoma protuberans (DFSP) is a rare dermal mesenchymal tumor known as a low-grade, slow-growing malignancy. The local invasion and high rate of recurrence following surgical treatment are the main concerns to plan the best surgical approach of treatment. Aims: In the current study, it is aimed to provide an experience of slow-Mohs surgery for the treatment of patients with DSFP. Patients/Methods: Number of 25 patients with the diagnosis of DFSP through histological and immunostaining study was included. The slow-Mohs was performed by excision of the tumor with margins accounting for 1–2 cm from both the tumor margins and three-dimensional thickness. The obtained tissue margins were horizontally, and if any of the specimens was not margin-free, the procedure was repeated. The patients' opinion about the procedure was assessed using Patient-Observer Scar Assessment Scale (POSAS). Results: Number of 25 patients were included and followed for a median of 46.9 months. The median of the area of excision was 35.56 cm2, and the median clinical excision margins were 19 mm (tumor excision margins + thickness of the three-dimensional excision). The surgery was performed once for 16 (64%), and postoperative skin closure within 5–7 days after the procedure was performed for 19 (76%) patients. None of the patients represented any recurrence. The patients' overall opinion and satisfaction POSAS score accounted for 2.3 ± 1.65 and 1.6 ± 0.59, respectively. Conclusion: The findings of the current study are in favor of slow-Mohs surgery for the management of DFSP, while more extensive studies are strongly recommended for generalization of this procedure. © 2020 Wiley Periodicals, Inc.