Abstract 871: Dermatofibrosarcoma protuberans in a black African population: A clinicopathologic study with emphasis on the predictors of recurrence and outcome

Abstract

Abstract Background: Dermatofibrosarcoma protuberans are relatively rare in our environment. Detailed studies on the subject in homogenous black African population are rare in literature. The aim of the study was to retrospectively analyze the clinical and histopathologic features of the tumor and identify the factors that directly influence recurrence, outcome and prognosis in the setting of a developing country with limited resources. Materials and Methods: All cases of Dermatofibrosarcoma protuberans histopathologically diagnosed and available from the files and records of Department of Pathology, University College Hospital, Ibadan, Nigeria between January 1989 and December 2007 were identified, reviewed and included in the study. The detailed clinical parameters like age at presentation, gender, size and site of tumor, stage at presentation, treatment modalities, recurrence and follow up details; also details of histopathologic features like mitotic count and presence of tumor at the resection margins were analyzed. Results: A total of 58 cases were identified and are presented. All the patients were Nigerians. Patient's age ranged from 5-74 years (median, 35years) with a modal age group of 30-39 years. The male/ female ratio had a male preponderance of 2.2:1. Tumor site distribution was trunk (39.5%), lower limb (27%), Upper limb (21%) and head and neck (12.5%). Tumor size ranged from 1.5 to 21cm. Seventy four percent presented with pT2 (TNM) stage tumor. Size of tumor larger than 7cm, mitotic count of greater than 7 per 10hpf and involvement of the subcutaneous tissue were strong indicators of the likelihood of recurrence. Forty five percent of our patients had recurrence with a patient having eight recurrences. The cost implications significantly delayed adjuvant therapy after surgical resection in our patients. This is because the cost of management is borne directly by patients in our environment. About 50% of our patients especially those with pT1 stage tumors were lost to follow up in less than 6 months. Two of our patients had features with fibrosarcoma-like transformation. Conclusion: The trunk and the lower limb accounted for 66.5% of location of tumor. The follow up data was poor in patients with small sized tumors. Large tumor size and high mitotic count increased the rate of recurrence. The cost implication of care, which is directly borne by patients due to out-of pocket payment lead to poor follow up and outcome. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 871.