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Underuse of Mohs Micrographic Surgery for the Treatment of Dermatofibrosarcoma Protuberans:  Comment on “Efficacy of Mohs Micrographic Surgery for the Treatment of Dermatofibrosarcoma Protuberans”

Fiona O. Zwald, MD
Arch Dermatol. 2012;148(9):1064. doi:10.1001/archdermatol.2012.2685.
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Dermatofibrosarcoma protuberans (DFSP) is a slow -growing, locally aggressive, spindle cell tumor. The aim of surgical therapy for DFSP is complete tumor resection, resulting in clear margins. However, DFSP is associated with high recurrence rates, particularly for larger tumors and for those occurring on the head and neck.

The article by Foroozan et al1 in this issue of the Archives systematically reviewed and assessed the quality of the published evidence on the recurrence rates of treatment with Mohs micrographic surgery (MMS) compared with wide local excision (WLE). The overall recurrence rates in nonrandomized comparative trials were 1.11% for MMS and 6.32% for WLE. A recent review confirmed low rates of DFSP recurrence (1% using MMS and 7.3% using WLE).2

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