Fibrosarcomatous changes (5-year EFS 52% vs 75%, p=0.002), lack of CD34 (33% vs 70%, p=0.05), and lack of apolipoprotein-D (33% vs 73%, p=0.02) were associated with worse outcomes in DFSP.
Cohort (n=40)
No
Do fibrosarcomatous changes, CD34 expression, and apolipoprotein-D expression influence outcomes in patients with dermatofibrosarcoma protuberans?
In patients with dermatofibrosarcoma protuberans, the presence of fibrosarcomatous changes, inadequate surgical margins, and lack of CD34 or apolipoprotein-D expression are associated with worse event-free survival.
Absolute Event Rate: 52% vs 75%
p-value: p=0.002
BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is a relatively common soft-tissue tumor. A more aggressive appearing fibrosarcoma may arise in DFSP, changing its biological behavior. CD34 and apolipoprotein-D are highly expressed in DFSP, but their prognostic significance is uncertain. METHODS: DFSP and fibrosarcomatous-DFSP (FS-DFSP) patients referred to our institute between 1982 and 2009 were identified. Fibrosarcomatous changes, expression of CD34 and apolipoprotein-D were evaluated. RESULTS: 40 patients, (median age 43 years, 55% males) were identified. Tumor was located in the limbs in 60%, in the trunk in 40%. Thirty-seven patients had localized and 3 had metastatic disease. Thirteen (32%) patients were FS-DFSP. All but one underwent surgery with adequate surgical margins in 72%. 7 FS-DFSP received also radiotherapy (RT). Chemotherapy was administered to 3 patients with FS-DFSP. With a median follow-up of 49 months, the 5-OS was 90%. Local recurrence rate was 23%: 42% FS-DFSP, 15% DFSP. Metastases developed in three FS-DFSP patients. The 5-year EFS was 70% in localized patients. Histology (DFSP 75% vs. FS-DFSP 52%, p = 0.002), surgical margins (adequate 74% vs. inadequate 55%, p = 0.02), site (limb 47% vs. trunk 100%), CD34 expression (CD34 positive: 70% vs. CD34 negative: 33%, p = 0.05), and apolipoprotein-D expression (Apo-D positive: 73% vs. Apo-D negative: 33%, p = 0.02) influenced the 5-year EFS, whereas sex, use of RT or number of previous surgical treatments did not. CONCLUSIONS: Patients with DFSP have a high survival probability. Site, adequate surgical margins, presence of the fibrosarcomatous component, lack of CD34 expression and apolipoprotein-D influence outcome.
Palmerini et al. (Wed,) conducted a cohort in Dermatofibrosarcoma protuberans (n=40). Fibrosarcomatous changes, CD34, and apolipoprotein-D expression vs. DFSP without fibrosarcomatous changes, CD34 positive, and Apo-D positive was evaluated on 5-year Event-Free Survival (EFS) (p=0.002). Fibrosarcomatous changes (5-year EFS 52% vs 75%, p=0.002), lack of CD34 (33% vs 70%, p=0.05), and lack of apolipoprotein-D (33% vs 73%, p=0.02) were associated with worse outcomes in DFSP.