The following is a summary of “Factors associated with time to surgical treatment for dermatofibrosarcoma protuberans,” published in the March 2024 issue of Dermatology by Wilkowski, et al.
For a study, researchers sought to identify factors associated with the time from diagnosis to definitive surgical treatment (TTDS) for patients diagnosed with dermatofibrosarcoma protuberans (DFSP).
A retrospective review of the National Cancer Database (NCDB) spanning from 2004 to 2019 was conducted to include patients diagnosed with DFSP, while those treated with excisional biopsy as definitive treatment were excluded. Multivariable logistic regression analysis assessed TTDS variances by sociodemographic characteristics and primary tumor site. Additionally, multivariable linear regression determined the contribution of each sociodemographic and disease characteristic to TTDS, measured in days. Statistical analyses were performed using R (version 4.1.3), with significance set at P < .05.
Among the 6,918 patients with DFSP analyzed, 7.7% were identified as Hispanic. After adjusting for sociodemographic factors and primary tumor site, Hispanic ethnicity was associated with increased odds of TTDS exceeding 90 days (adjusted odds ratio [aOR] 1.56, 95% CI 1.19-2.05, P = .001). Conversely, no significant TTDS delays were observed for Black patients. Tumors located on the head/neck were associated with higher odds of TTDS within 61-90 days (aOR 1.55, 95% CI 1.25-1.93, P < .0001) and beyond 90 days (aOR 1.66, 95% CI 1.32-2.08, P < .001). Additionally, Medicaid insurance was linked to approximately double the odds of TTDS surpassing 90 days (aOR 1.74, 95% CI 1.37-2.22, P < .0001). Notably, head/neck tumor site and Medicaid insurance were associated with an additional 11.72 and 8.37 days, respectively, from diagnosis to surgical treatment (P < .05).
The study identified Hispanic ethnicity, head/neck tumor site, and Medicaid insurance as factors associated with delays in TTDS for DFSP patients. Understanding these factors can inform strategies to optimize timely surgical intervention and improve outcomes for individuals with DFSP. Further research was warranted to explore interventions to reduce disparities in access to surgical care for DFSP patients.