Persa, O. D., Loquai, C., Wobser, M., Baltaci, M., Dengler, S., Kreuter, A., Volz, A., Laimer, M., Emberger, M., Doerler, M., Mauch, C. and Helbig, D. (2019). Extended surgical safety margins and ulceration are associated with an improved prognosis in pleomorphic dermal sarcomas. J. Eur. Acad. Dermatol. Venereol., 33 (8). S. 1577 - 1581. HOBOKEN: WILEY. ISSN 1468-3083

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Abstract

Background Pleomorphic dermal sarcomas (PDS) are frequent UV-induced sarcomas of the skin of intermediate grade malignant potential. Despite the fact that PDS have a noteworthy potential to recur (up to 28%) as well as to metastasize (up to 20%), there are no specific clinical guidelines with respect to follow-up these patients. Moreover, little is known about clinical, histological or molecular prognostic factors in PDS. Objective The aim of the present study was to identify risk factors to predict relapse in a large multicentre sample cohort of PDS which could aid to optimize personalized treatment recommendations regarding surgical safety margins and adjuvant radiotherapy. Methods Patients with a diagnosis of PDS were selected from nine European institutions based on the histopathologic criteria described by Fletcher. Clinicopathologic and follow-up data were collected and statistically analysed calculating univariate hazard ratios with 95% confidence intervals by use of the Cox proportional-hazards model and a significance level of P < 0.05. Patients with an incomplete excision of the tumour were excluded. Results Univariate Cox regression analysis of possible prognostic factors for progression-free survival (PFS) performed in 92 patients revealed that an excision margin of PDS [hazard ratio 4.478 (95% CI 1.536-13.055), P = 0.006]. Ulceration of the tumour was associated with a significantly better prognosis [0.396 (0.174-0.904), P = 0.028] whereas adjuvant radiotherapy did not reach statistical significance to improve prognosis in patients with PDS [0.775 (0.231-2.593), P = 0.679]. Gender, age, immunosuppression, intratumoural necrosis, tumour location, vertical thickness or horizontal diameter did not significantly influence PFS in PDS. Conclusion We identified surgical safety margins of PDS. These findings may be implemented into both the primary treatment as well as the further monitoring of patients with PDS.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Persa, O. D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Loquai, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wobser, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baltaci, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dengler, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kreuter, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Volz, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Laimer, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Emberger, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Doerler, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mauch, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Helbig, D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-133899
DOI: 10.1111/jdv.15493
Journal or Publication Title: J. Eur. Acad. Dermatol. Venereol.
Volume: 33
Number: 8
Page Range: S. 1577 - 1581
Date: 2019
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1468-3083
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ATYPICAL FIBROXANTHOMASMultiple languages
DermatologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/13389

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