Date of Award

11-3-2006

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Deepak Narayan

Abstract

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 cm2 ± 16.1 (SE) and 5.3 cm2 ± 5.9 (MS), and the mean excisional margins were 3.8 cm ± 1.6 (SE) and 1.4 cm± 0.5 (MS). The mean duration of follow-up in the SE group was 33 months ± 41 (range: 1-116 months), and the mean duration of follow-up in the MS group was 26 months ± 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, 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.

Comments

This is an Open Access Thesis.

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