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Dermatofibrosarcoma protuberans: Surgical excision versus Mohs surgery

The purpose of this project was to compare the recurrence rates of dermatofibrsarcoma protuberans (DFSP) treated with surgical excision (SE) and Mohs surgery (MS) at Yale. Patients were identified through the dermatopathology laboratory database and stratified by treatment. The following information was collected: age at onset, sex, disease state (primary presentation versus recurrence), tumor site, preoperative tumor size, postoperative defect size, excisional margin, duration of follow-up, and recurrence after treatment. Of the 30 patients, 14 were in the SE group, and 16 were in the MS group. There were no recurrences in the SE group, and there was 1 recurrence (6%) in the MS group, which occurred 37 months post-operatively. The average area of the tumors were 12.1 cm[exponent]2 [plus-minus] 16.1 (SE) and 5.3 cm[exponent]2 [plus-minus] 5.9 (MS), and the mean excisional margins were 3.8 cm [plus-minus] 1.6 (SE) and 1.4 cm [plus-minus] 0.5 (MS). The mean duration of follow-up in the SE group was 33 months [plus-minus] 41 (range: 1-116 months), and the mean duration of follow-up in the MS group was 26 months [plus-minus] 25 (range: 2 to 69 months.) Although the MS group had a higher recurrence rate than the SE group, using the recurrence rates to make meaningful conclusions about the efficacy of the two treatment modalities is limited by the small n[italicized], lack of randomization to either procedure, and duration of follow-up. Once these issues are addressed, recurrence rates must also be adjusted for patient and tumor characteristics, that are associated with higher recurrence rates.

Identiferoai:union.ndltd.org:YALE_med/oai:ymtdl.med.yale.edu:etd-06272006-101224
Date03 November 2006
CreatorsChung, Connie
ContributorsDeepak Narayan
PublisherYale University
Source SetsYale Medical student MD Thesis
LanguageEnglish
Detected LanguageEnglish
Typetext
Formatapplication/pdf
Sourcehttp://ymtdl.med.yale.edu/theses/available/etd-06272006-101224/
Rightsunrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to Yale School of Medicine or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report.

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