Atypical Fibroxanthoma and Pleomorphic Dermal Sarcoma: A Retrospective Review and Survival Analysis at a Single Academic Institution.

IF 2.5 3区医学 Q2 DERMATOLOGY

Dermatologic Surgery Pub Date : 2025-01-06 DOI:10.1097/DSS.0000000000004536

Michael Franzetti, Landon Hendrickson, Thomas Knackstedt, Lindsey Collins

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引用次数: 0

Abstract

Background: Prognostication of atypical spindle cell neoplasms, including atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS), is challenging; outcomes vary widely, and further identification of prognostic features is crucial.

Objective: To evaluate prognostic factors that may portend worse outcomes in patients with AFX and PDS.

Materials and methods: A retrospective chart review of patients with AFX and PDS was conducted. Data were analyzed using Pearson chi square and T-test. Survival was analyzed using the Kaplan-Meier estimate. A stepwise cox proportional hazards model was created to identify variables associated with increased risk of poor outcomes.

Results: Thirty-four patients with AFX and 10 patients with PDS were identified. PDS had a 60% overall mortality rate (vs 26.5% in AFX), a larger preoperative size of 8.9 cm2 (vs 2.4 cm2) (p < .0001), and a 50% recurrence rate (vs 5.9%) (p = .0039). Female gender (HR 22.18 95% CI 2.54-194.13; p = .001), immunosuppression (HR 5.02 95% CI 1.32-19.12; p = .0044), and perineural invasion (PNI) (HR 78.46 3.97-1,549.56; p = .0091) were associated with increased risk of poor outcomes.

Conclusion: Few large studies have examined clinical features that portend worse outcomes. The authors identify female gender, immunosuppression, and PNI as variables associated with increased risk of recurrence or death.

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来源期刊

Dermatologic Surgery 医学-皮肤病学

CiteScore

3.10

自引率

16.70%

发文量

547

期刊介绍： Exclusively devoted to dermatologic surgery, the Dermatologic Surgery journal publishes the most clinically comprehensive and up-to-date information in its field. This unique monthly journal provides today’s most expansive and in-depth coverage of cosmetic and reconstructive skin surgery and skin cancer through peer-reviewed original articles, extensive illustrations, case reports, ongoing features, literature reviews and correspondence. The journal provides information on the latest scientific information for all types of dermatologic surgery including: -Ambulatory phlebectomy- Blepharoplasty- Body contouring- Chemical peels- Cryosurgery- Curettage and desiccation- Dermabrasion- Excision and closure- Flap Surgery- Grafting- Hair restoration surgery- Injectable neuromodulators- Laser surgery- Liposuction- Microdermabrasion- Microlipoinjection- Micropigmentation- Mohs micrographic surgery- Nail surgery- Phlebology- Sclerotherapy- Skin cancer surgery- Skin resurfacing- Soft-tissue fillers. Dermatologists, dermatologic surgeons, plastic surgeons, oculoplastic surgeons and facial plastic surgeons consider this a must-read publication for anyone in the field.