What Is the First-Line Surgical Treatment for Dermatofibrosarcoma Protuberans (DFSP)?

Dermatofibrosarcoma protuberans (DFSP) is a soft tissue tumour for which initial treatment is surgical. The central clinical goal is complete tumour removal with negative surgical margins, and the choice of surgical technique is guided by margin assessment capability.

Treatment Approach

First-line management relies on a form of surgical excision specifically chosen for its margin assessment characteristics — the full protocol specifies the preferred technique and when alternative approaches apply.

Clinical Goal

The primary objective is negative surgical margins. Every effort should be made to achieve clear surgical margins before any further management is considered.

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References

Initial treatment of DFSP is surgical.
Excision with Mohs micrographic surgery (Mohs) or other forms of peripheral and deep en face margin assessment (PDEMA) is recommended over WLE.
If Mohs or other forms of PDEMA are unavailable, consider wide excision.
Every effort should be made to achieve clear surgical margins.

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