Document Detail

Efficacy of Mohs micrographic surgery for the treatment of dermatofibrosarcoma protuberans: systematic review.
MedLine Citation:
PMID:  22986859     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE To summarize evidence about the recurrence of dermatofibrosarcoma protuberans (DFSP) following Mohs micrographic surgery (MMS). DATA SOURCES MEDLINE, Cochrane Library, EMBASE, Pascal, Biosis, CisMef, BDSP, Scopus, and Web of Knowledge databases were searched for the period January 1, 1995, to August 31, 2011. Search terms were Mohs micrographic surgery, dermatofibrosarcoma protuberans, and their synonyms. No language restriction was used. STUDY SELECTION Two of us selected randomized controlled trials or nonrandomized trials comparing the recurrence of DFSP among patients undergoing MMS vs wide local excision. The search retrieved 384 references, of which 31 were reviewed in detail. DATA EXTRACTION Twenty-three nonrandomized trials (4 comparative and 19 noncomparative) were included, from which data were extracted by 2 of us independently. The methodological quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. DATA SYNTHESIS Moderate-quality evidence (level B) was found for recurrence of DFSP after MMS (1.11%; 95% CI, 0.02%-6.03%) vs after wide local excision (6.32%, 95% CI, 3.19%-11.02%). A mean raw recurrence rate of 1.03% (95% CI, 0.37%-2.22%) was found after MMS among 19 nonrandomized noncomparative trials (low-quality evidence [level C]). The mean follow-up periods ranged from 26 to 127 months. The mean time to recurrence was 68 months. CONCLUSIONS A weak recommendation is given in favor of MMS or similar surgical techniques with meticulous histologic evaluation of all margins as the first-line therapy for DFSP, particularly in recurrence-prone regions. Attention should be given to longer than a 5-year follow-up period. High-quality trials with sufficient follow-up periods should be encouraged.
Majid Foroozan; Jean-François Sei; Mona Amini; Alain Beauchet; Philippe Saiag
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Archives of dermatology     Volume:  148     ISSN:  1538-3652     ISO Abbreviation:  Arch Dermatol     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-18     Completed Date:  2012-12-03     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  0372433     Medline TA:  Arch Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1055-63     Citation Subset:  AIM; IM    
Department of Dermatology and Research Unit EA 4339 “Skin, Environment, and Cancer,” Ambroise Paré University Hospital, France.
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MeSH Terms
Dermatofibrosarcoma / surgery*
Mohs Surgery*
Comment In:
Arch Dermatol. 2012 Sep;148(9):1064   [PMID:  22986860 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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