Role of postoperative radiotherapy in dermatofibrosarcoma protuberans: a propensity score-matched analysis.

Abstract

OBJECTIVE:

This study aimed to evaluate the role of postoperative radiotherapy (RT) in dermatofibrosarcoma protuberans (DFSP) and identify the prognostic factors influencing the disease-free survival (DFS).

METHODS:

A total of 184 patients with DFSP were analyzed from 2000 to 2016. The regression model was used to examine the prognostic factors for DFS. Baseline covariates were balanced using a propensity score model. The role of RT was assessed by comparing the DFS of the surgery + RT group with that of the surgery group.

RESULTS:

The median follow-up was 58 months (range, 6-203 months). The 5-year DFS rate was 89.8%. The univariate analysis showed that age ≥ 50 years, presence of fibrosarcoma, margins < 2 cm, and tumor size ≥5 cm were associated with worse DFS (P = 0.002, P <  0.001, P = 0.030, and P = 0.032, respectively). The multivariate Cox regression model revealed that age, margin width, lesion number, and histological subtype independently affected DFS. The Ki-67 expression was related to age and histological subtype. Patients with Ki-67 ≥ 17% showed a worse DFS than those with Ki-67 < 17% (35.8% vs 87.8%, P = 0.002). In the matched cohort, DFS was significantly higher in the S + RT group than in the S group (5-year DFS, 88.1% vs 56.2%, P = 0.044).

CONCLUSIONS:

Age, margin width, lesion number, and histological subtype were independent risk factors for DFS in patients with DFSP. The high expression of Ki-67 could predict a poor prognosis. Postoperative RT could improve DFS for patients with DFSP.

• Authors: Kaixin Du, Jinluan Li, Lirui Tang, Xiaoyi Lin, Xiangquan Kong, Xuehong Liao, Qingqin Peng, Yaping Dong, Junyan He, Yunxia Huang, Xueqing Zhang, Feifei Lin, Qingyang Zhuang, Junxin Wu
• Journal: Radiation oncology (London, England) (Radiat Oncol) Vol. 14 Issue 1 Pg. 20 (Jan 29 2019) ISSN: 1748-717X [Electronic] England
• PMID: 30696463 (Publication Type: Journal Article)

Topics

• Cohort Studies
• Dermatofibrosarcoma (pathology, radiotherapy)
• Female
• Humans
• Male
• Middle Aged
• Neoplasm Recurrence, Local (pathology, radiotherapy)
• Postoperative Care
• Prognosis
• Propensity Score
• Radiotherapy (mortality)
• Skin Neoplasms (pathology, radiotherapy)
• Survival Rate