Dermatofibrosarcoma protuberans (DFSP): predictors of recurrence and the use of systemic therapy

Fields, R. C., Hameed, M., Qin, L. X., Moraco, N., Jia, X., Maki, R. G., Singer, S., Brennan, M. F. (February 2011) Dermatofibrosarcoma protuberans (DFSP): predictors of recurrence and the use of systemic therapy. Ann Surg Oncol, 18 (2). pp. 328-36. ISSN 1534-4681 (Electronic)1068-9265 (Linking)

DOI: 10.1245/s10434-010-1316-5


BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue malignancy that typically presents with local invasion but rarely metastasizes. We examine clinicopathologic factors associated with disease-free survival (DFS) in patients with primary and recurrent DFSP and evaluate responses to multimodality therapy. MATERIALS AND METHODS: Patients treated for DFSP were identified in a prospectively maintained database. Clinicopathologic factors associated with DFS were analyzed using univariate and multivariate analysis. RESULTS: A total of 244 patients with DFSP were identified. Median follow-up was 50 months. A total of 14 patients had local recurrence (LR), and 2 patients had distant recurrence (DR), with a median time to recurrence of 35 months. At time of last follow-up, 70% and 47% of patients showed no evidence of disease (NED) in the primary (n = 197) and recurrent groups (n = 47), respectively. On univariate analysis, tumor location and depth were associated with DFS in the primary group, while margin status (R1 vs. R0) was associated with DFS in the LR group. On multivariate analysis, only depth (primary group) and margin status (LR group), remained significant. Also, 22 patients had therapy other than surgical resection: 14 radiotherapy, 4 tyrosine kinase inhibitor (TKI) only, 2 conventional chemotherapy only, and 2 chemotherapy plus TKI. Responses to other therapies were variable. CONCLUSIONS: DFS after treatment for DFSP is strongly predicted by tumor depth in the primary setting and margin status in recurrent tumors. The treatment for DFSP in the primary or recurrent setting is excision with negative margins, resulting in low recurrence rates and infrequent metastatic spread. Multimodality treatment, especially TKI use, can be effective, but is not curative.

Item Type: Paper
Uncontrolled Keywords: Adolescent Adult Aged Antineoplastic Combined Chemotherapy Protocols/*therapeutic use Combined Modality Therapy Dermatofibrosarcoma/pathology/therapy Female Follow-Up Studies Humans Male Middle Aged Neoplasm Recurrence, Local/*diagnosis/*therapy Prospective Studies Radiotherapy Dosage Survival Rate Treatment Outcome Young Adult
Subjects: diseases & disorders > cancer > drugs and therapies
diseases & disorders > cancer > prognosis
diseases & disorders > cancer > cancer types > sarcoma
CSHL Authors:
Communities: CSHL labs > Maki lab
Depositing User: Matt Covey
Date: February 2011
Date Deposited: 21 Oct 2016 19:41
Last Modified: 21 Oct 2016 19:41
PMCID: PMC4310211
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