Outcomes and prognostic factors of surgically treated extramammary Paget's disease of the vulva.

Publisher: Asian Society of Gynecologic Oncology Country of Publication: Korea (South) NLM ID: 101483150 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2005-0399 (Electronic) Linking ISSN: 20050380 NLM ISO Abbreviation: J Gynecol Oncol Subsets: MEDLINE

Publication: June 2011-: Seoul : Asian Society of Gynecologic Oncology : Taehan Puin Chongyang Hakhoe
Original Publication: Seoul : Korean Society of Gynecologic Oncology and Colposcopy, June 2008-

Paget Disease, Extramammary*/surgery ; Paget Disease, Extramammary*/pathology ; Vulvar Neoplasms*/surgery ; Vulvar Neoplasms*/pathology; Humans ; Female ; Prognosis ; Retrospective Studies ; Margins of Excision ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/pathology ; Vulva/surgery ; Vulva/pathology ; Postoperative Complications/epidemiology

Objective: Extramammary Paget's disease (EMPD) of the vulva is a rare disease which predominantly presents in postmenopausal Caucasian women. As yet, no studies on Asian female patients with EMPD have been performed. This study aimed to identify the clinical features of patients with vulvar EMPD in Korea, and to evaluate the risk factors of recurrence and postoperative complications in surgically treated EMPD.
Methods: We retrospectively reviewed 47 patients with vulvar EMPD who underwent wide local excision or radical vulvectomy. The clinical data and surgical and oncological outcomes following surgery were extracted from medical records and analyzed. Univariate and multivariate analyses for predicting recurrence and postoperative complications were performed.
Results: 21.3% of patients had complications after surgery, and wound dehiscence was the most common. 14.9% of patients experienced recurrence, and the median interval to recurrence from initial treatment was 69 (range 33-169) months. Vulvar lesions larger than 40 mm was the independent risk factor of postoperative complications (odds ratio [OR]=7.259; 95% confidence interval [CI]=1.545-34.100; p=0.012). Surgical margin status was not associated with recurrence in surgically treated vulvar EMPD patients (OR=0.83; 95% CI=0.16-4.19; p=1.000).
Conclusion: Positive surgical margin is a frequent finding in the patients with vulvar EMPD, but disease recurrence is not related with surgical margin status. Since EMPD is a slow growing tumor, a surveillance period longer than 5 years is required.
Competing Interests: No potential conflict of interest relevant to this article was reported.
(© 2023. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.)

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Keywords: Surgical margin; Vulvar disease; Vulvar neoplasm

Date Created: 20230721 Date Completed: 20231107 Latest Revision: 20231108

20240829

PMC10627755

10.3802/jgo.2023.34.e76

37477099