Table I.
Patient demographics and atypical fibroxanthoma characteristics by treatment type
| Characteristics, N (%) | MMS (N = 50) | WLE (N = 6)∗ | Total (N = 56) | P value |
|---|---|---|---|---|
| Age at diagnosis, y† | 75.3 (12.5) | 61.0 (18.1) | 73.7 (13.7) | .015 |
| Sex | .289 | |||
| Male | 42 (84.0) | 4 (66.7) | 46 (82.1) | |
| Female | 8 (16.0) | 2 (33.3) | 10 (17.9) | |
| Race | N/A | |||
| White | 45 (100.0) | 6 (100.0) | 51 (100.0) | |
| Not reported | 5 | 0 | 5 | |
| CCI score†,‡ | 7.4 (2.7) | 6.7 (3.8) | 7.3 (2.8) | .562 |
| Prior skin cancer diagnosis | 41 (82.0) | 4 (66.7) | 45 (80.4) | .586 |
| SCC | 31 (62.0) | 4 (66.7) | 35 (62.5) | |
| BCC | 33 (66.0) | 3 (50.0) | 36 (64.3) | |
| Melanoma | 10 (20.0) | 2 (33.3) | 12 (21.4) | |
| Tumor location | .008 | |||
| Face | 21 (42.0) | 1 (16.7) | 22 (39.3) | |
| Scalp | 27 (54.0) | 2 (33.3) | 29 (51.8) | |
| Neck | 0 (0) | 1 (16.7) | 1 (1.8) | |
| Trunk | 0 (0) | 1 (16.7) | 1 (1.8) | |
| Upper extremity | 1 (2.0) | 1 (16.7) | 2 (3.6) | |
| Lower extremity | 1 (2.0) | 0 (0) | 1 (1.8) | |
| Radiation exposure to AFX site | 2 (4.0) | 3 (50.0) | 5 (8.9) | .007 |
| Immunosuppressed | 3 (6.0) | 1 (16.7) | 4 (7.1) | .373 |
| Tumor size at diagnosis, cm† | 1.0 (0.8) | 2.6 (2.6) | 1.2 (1.1) | .002 |
| Time to treatment, mo† | 40.1 (35.8) | 57.5 (55.9) | 42.0 (38.2) | .295 |
| Mohs stages | 1.4 (0.5) | N/A | 1.4 (0.5) | N/A |
| WLE margins, cm§ | N/A | 1.3 (0.5-2) | 1.3 (0.5-2) | N/A |
| Up-diagnosis | 3 (6.0) | 1 (16.7) | 4 (7.1) | .373 |
| Up-diagnosis type | 1.00 | |||
| UPS | 1 (2.0) | 1 (16.7) | 2 (3.6) | |
| MFH | 1 (2.0) | 0 (0.0) | 1 (1.8) | |
| PDS | 1 (2.0) | 0 (0.0) | 1 (1.8) | |
| Treatment sequela | .084 | |||
| Distant recurrence/metastasis | 1 (2.0) | 0 (0.0) | 1 (1.8) | |
| Local recurrence | 2 (4.0) | 2 (33.3) | 4 (7.1) | |
| No return | 47 (94.0) | 4 (66.7) | 51 (91.1) | |
| Time to recurrence, mo† | 13.7 (6.5) | 27 (29.7) | 19 (17.2) | .322 |
| No. of recurrences per patient† | 2.7 (1.2) | 1.0 (0.0) | 2.0 (1.2) | .148 |
| Follow-up status | 1.00 | |||
| Alive | 42 (84.0) | 5 (83.3) | 47 (83.9) | |
| Dead due to other cause | 8 (16.0) | 1 (16.7) | 9 (16.1) | |
| Follow up time, y† | 4.4 (3.6) | 3.3 (2.7) | 4.3 (3.5) | .387 |
No significant differences were observed in the recurrence rates between groups. Those treated with WLE had significantly larger sized tumors (P = .002), younger ages of diagnosis (P = .015), and a larger proportion of patients that had prior radiation exposure to AFX site (P = .007). Notably, 96.0% of those with MMS had tumors located on the head and neck, compared to 66.7% in those with WLE. Two sample t tests were used to compare continuous variables, and Fisher’s exact tests were used to compare categorial variables between groups.
AFX, Atypical fibroxanthoma; BCC, basal cell carcinoma; CCI, Charlson Comorbidity Index; MFH, malignant fibrous histiocytoma; MMS, mohs micrographic surgery; PDS, pleomorphic dermal sarcoma; SCC, squamous cell carcinoma; UPS, undifferentiated pleomorphic sarcoma; WLE, wide local excision.
Of the 6 WLE cases, 3 were performed by otolaryngology, and 1 by general surgery; 2 did not have this information available. WLE was recommended over Mohs in the 6 included cases for the following reasons: surrounding SCC and recurrent BCC (previously excised with postoperative radiotherapy) found on initial AFX biopsy (n = 1); rapidly enlarging and concern for depth of tumor (n = 2); concern for depth of tumor as AFX was transected at all margins on initial biopsy (n = 1); reason not reported (n = 2).
Mean (standard deviation).
CCI, or Charlson Comorbidity Index, represents the number of comorbid diseases in a patient and predicts the 10-year mortality. Higher scores represent a greater number and/or more severe comorbid diseases.
Mean (range).