Mr Myles Smith was a co-author in two related publications which investigated the size of surgical excision margins needed to safely treat DFSP, and need for reconstruction. In the paper ‘Conservative Re-excision is a Safe and Simple Alternative to Radical Resection in Revision Surgery for Dermatofibrosarcoma Protuberans’, published in the Annals of Surgical Oncology by Mr Hayden Snow, the authors found that in the experience of the Royal Marsden Sarcoma Unit, a conservative re-excision of margins was a safe and acceptable compared to a traditional wide excision.
In another similar publication, which examined the adequacy of excision margins of DFSP in 3 specialist centres, Dr Huis in’t Veld and colleagues found that in specialist centres, the majority of patients had clear margins with one operation only, and that there was no improvement in the recurrence rate when the margins were greater than 1cm.
The conclusions of the study were that the wider the margins taken, the more likely one was to attain clear margins, with the trade-off being more frequent plastic reconstruction. Therefore, the width of excision margin taken to clear the DFSP must be balanced with the need for reconstruction, in the context that conservative excision is likely to be sufficient to remove the tumour and eliminate recurrence.