Objective: To evaluate the prognosis of dermatofibrosarcoma protuberans (DFSP) in head and neck after deferent treatment.
Methods: The clinical data of 28 cases of DFSP in head and neck from 1982 to 2005 were analyzed retrospectively. Eleven cases were treated with wide excision, and 17 with limited excision. Twenty four cases had surgical resection alone (S), and 4 preoperative or postoperative radiotherapy (S + R) of 40-65 Gy. Eighteen cases received immediate reconstruction.
Results: The overall recurrence rate was 21.4% (6/28), the recurrence rate of wide excision group was 0 (0/11), compared with 35.3% (6/17) in the limited excision group (P = 0.033); the recurrence rate of S + R group was 0 (0/4), compared with 25.0% (6/24) in S group, but there was no significant deference (P = 0.357). The overall 5-year survival rate was 88.9%. The 5-year recurrence free survival rate was 100% in wide excision group, compared with 59.6% in the limited excision group (chi2 = 3.933, P = 0.047).
Conclusions: Wide excision could significantly reduce the recurrence rate of DFSP in head and neck, when the adequate margin couldn't be achieved or the excision margin was positive, adjuvant radiotherapy might be helpful. The immediate reconstruction was necessary when the defect was large.