Key Recommendations : Skin Sarcomas
1) Treatment of DFSP is wide surgical excision. In the case of an initial inadvertent enucleation of a DFSP, in the absence of macroscopic residual disease, a wide excision but with primary closure is an appropriate initial surgical strategy. Mohs surgery may be appropriate in selected cases to reduce functional loss at critical anatomical sites.(IV,C)
2) Adjuvant radiotherapy may be considered if surgical resection is incomplete, and re-excision not possible.(IV,A)
3) Imatinib may provide an option for neoadjuvant treatment in borderline resectable disease, or effective palliation for patients with unresectable DFSP
4) AFX is usually cured by surgical excision, although tumours with adverse pathological features are regarded as pleomorphic dermal sarcomas. Rarely metastases can occur.(IV,A)
5) Large subcutaneous pleomorphic dermal sarcomas should be diagnosed preoperatively by a core/ punch biopsy and surgery planned, taking into account the need for possible postoperative radiotherapy. (IV,B)