Time to recurrence after surgical excision of atypical fibroxanthoma-updated systematic review and meta-analysis

Atypical fibroxanthoma (AFX) remains a rare cutaneous dermally based fibrohistiocytic tumour with high rates of local recurrence. Mohs micrographic surgery (MMS) and wide local excision (WLE) with margins 1–2 cm are two surgical options. It is unclear whether timing of recurrence following surgical excision of AFX differs according to technique. A systematic review and meta-analysis were performed according to PRISMA guidelines. There was a total of 188 MMS cases and 783 WLE cases. The pooled proportion of MMS cases of recurrence is 6.6% (95% CI 3.6–11.9%), compared with WLE 11.3% (95% CI 7.1–16.5%), which was not significantly different (P = 0.12) Pooled time to recurrence of MMS for AFX to be 14.2 (95% CI 11.6–16.8%) months, compared to 13.3 (95% CI 9.99–16.6%) months (P = 0.86). Our findings suggest that recurrence rates are similar between MMS and WLE techniques and that timing of recurrence is similar regardless of surgical technique employed.