Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2021; 9(20): 5442-5452
Published online Jul 16, 2021. doi: 10.12998/wjcc.v9.i20.5442
Risk factors related to postoperative recurrence of dermatofibrosarcoma protuberans: A retrospective study and literature review
Jian-Xia Xiong, Tao Cai, Li Hu, Xiao-Li Chen, Kun Huang, Ai-Jun Chen, Ping Wang
Jian-Xia Xiong, Tao Cai, Li Hu, Xiao-Li Chen, Kun Huang, Ai-Jun Chen, Ping Wang, Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
Author contributions: Xiong JX and Wang P contributed equally to this work; Xiong JX, Cai T, Hu L, and Wang P designed the research study; Xiong JX acquired the clinical data; Wang P and Chen XL performed the research; Chen AJ consulted the literature relevant to DFSP; Huang K contributed analytic tools; Xiong JX and Wang P analyzed the data and wrote the manuscript; Cai T revised the manuscript; all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the First Affiliated Hospital of Chongqing Medical University Institutional Review Board (No. 2020-653).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare that there is no conflict of interests regarding the publication of this paper.
Data sharing statement: Statistical code, and data set available from the corresponding author at (email: wang_ping@zju.edu.cn). Participants gave informed consent for data sharing but the presented data are anonymized and risk of identification is low.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ping Wang, PhD, Doctor, Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400010, China. wang_ping@zju.edu.cn
Received: January 19, 2021
Peer-review started: January 19, 2021
First decision: April 15, 2021
Revised: April 20, 2021
Accepted: May 19, 2021
Article in press: May 19, 2021
Published online: July 16, 2021
Processing time: 169 Days and 3.3 Hours
Abstract
BACKGROUND

Dermatofibrosarcoma protuberans (DFSP) is a rare low-grade malignant soft tissue tumor characterized by rosette-like infiltrative growth. Postoperative recurrence of this tumor is very common.

AIM

To evaluate the risk factors related to recurrence after wide local excision (WLE) of DFSP and to guide clinical diagnosis and treatment.

METHODS

The medical records of 44 DFSP patients confirmed by pathology at our hospital from 2012 to 2019 were retrospectively reviewed. The relationship between clinical features, tumor characteristics, treatment, and recurrence risk were analyzed, and the possible risk factors for postoperative tumor recurrence were evaluated.

RESULTS

There were 44 patients in total, including 21 males and 23 females. The median progression free survival was 36 mo (range, 1-240 mo). Twenty patients were treated for the first time, while 24 had previous treatment experience. Forty-two cases were followed for 25.76 ± 22.0 mo, among whom four (9.52%) experienced recurrence after WLE (rate was 9.52%). The recurrence rate in the recurrent group was higher than that in the patients with primary tumor (19.05% vs 0%, P = 0.028). Eighteen cases had a history of misdiagnosis (rate was 40.91%). The recurrence rate among patients with previous experience of misdiagnosis was significantly higher than in patients without (68% vs 36.84%, P = 0.04). The tumor diameter in patients with a history of treatment was larger than in patients treated for the first time (4.75 ± 0.70 cm vs 2.25 ± 0.36 cm, P = 0.004).

CONCLUSION

To sum up, the clinical manifestations of DFSP are not specific and are easily misdiagnosed, thus commonly causing the recurrence of DFSP. After incomplete resection, the tumor may rapidly grow. Previous recurrence history may be a risk factor for postoperative recurrence, and tumor location may have an indirect effect on postoperative recurrence; however, we found no significant correlation between sex, age, course of the disease, or tumor size and postoperative recurrence.

Keywords: Dermatofibrosarcoma protuberans; Recurrence; Clinical features; Wide local excision; Surgery; Retrospective research

Core Tip: Dermatofibrosarcoma protuberans (DFSP) is a rare malignant skin tumor with rosette-like infiltrative growth. Recurrence after excision of tumor is common; however, the risk factors for recurrence are not clear. This work was to evaluate the risk factors that may be associated with the recurrence after wide local excision of DFSP. We retrospectively analyzed the clinical characteristics of 44 DFSP patients and possible factors that may related to the recurrence of tumor excision from our department.