Therapeutic outcomes and survival analysis of Extramammary Paget's disease: A multicentre retrospective study of 249 patients
Background: Evidence regarding long-term therapeutic outcomes and disease-specific survival (DSS) in Extramammary Paget's disease (EMPD) is limited. Objectives: To assess the DSS and outcomes of surgical and nonsurgical therapeutic modalities in a large cohort of EMPD patients. Methods: Ret...
| Autores: | , , , |
|---|---|
| Tipo de recurso: | artículo |
| Estado: | Versión aceptada para publicación |
| Fecha de publicación: | 2024 |
| País: | España |
| Institución: | Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| Repositorio: | Recercat. Dipósit de la Recerca de Catalunya |
| OAI Identifier: | oai:recercat.cat:10230/60242 |
| Acceso en línea: | http://hdl.handle.net/10230/60242 http://dx.doi.org/10.1016/j.jaad.2023.08.088 |
| Access Level: | acceso abierto |
| Palabra clave: | Extramammary Paget&apos s disease Mohs micrographic surgery Imiquimod Local recurrence Margin status Radiotherapy |
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Therapeutic outcomes and survival analysis of Extramammary Paget's disease: A multicentre retrospective study of 249 patientsEscolà, HelenaLeal, LorenaPujol Vallverdú, Ramón M.Deza Vargas, Luis GustavoExtramammary Paget&aposs diseaseMohs micrographic surgeryImiquimodLocal recurrenceMargin statusRadiotherapyBackground: Evidence regarding long-term therapeutic outcomes and disease-specific survival (DSS) in Extramammary Paget's disease (EMPD) is limited. Objectives: To assess the DSS and outcomes of surgical and nonsurgical therapeutic modalities in a large cohort of EMPD patients. Methods: Retrospective chart review of EMPD patients from 20 Spanish tertiary care hospitals. Results: Data on 249 patients with a median follow-up of 60 months were analyzed. The estimated 5-, 10-, and 15-year DSS was 95.9%, 92.9%, and 88.5%, respectively. A significantly lower DSS was observed in patients showing deep dermal invasion (≥1 mm) or metastatic disease (P < .05). A ≥50% reduction in EMPD lesion size was achieved in 100% and 75.3% of patients treated with surgery and topical therapies, respectively. Tumor-free resection margins were obtained in 42.4% of the patients after wide local excision (WLE). The 5-year recurrence-free survival after Mohs micrographic surgery (MMS), WLE with tumor-free margins, WLE with positive margins, radiotherapy, and topical treatments was 63.0%, 51.4%, 20.4%, 30.1%, and 20.8%, respectively. Limitations: Retrospective design. Conclusions: EMPD is usually a chronic condition with favorable prognosis. MMS represents the therapeutic alternative with the greatest efficacy for the disease. Recurrence rates in patients with positive margins after WLE are similar to the ones observed in patients treated with topical agents.Elsevier20242024info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/60242http://dx.doi.org/10.1016/j.jaad.2023.08.088reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésJ Am Acad Dermatol. 2024 Jan;90(1):66-73© Elsevier http://dx.doi.org/10.1016/j.jaad.2023.08.088info:eu-repo/semantics/openAccessoai:recercat.cat:10230/602422026-05-29T05:05:01Z |
| dc.title.none.fl_str_mv |
Therapeutic outcomes and survival analysis of Extramammary Paget's disease: A multicentre retrospective study of 249 patients |
| title |
Therapeutic outcomes and survival analysis of Extramammary Paget's disease: A multicentre retrospective study of 249 patients |
| spellingShingle |
Therapeutic outcomes and survival analysis of Extramammary Paget's disease: A multicentre retrospective study of 249 patients Escolà, Helena Extramammary Paget&apos s disease Mohs micrographic surgery Imiquimod Local recurrence Margin status Radiotherapy |
| title_short |
Therapeutic outcomes and survival analysis of Extramammary Paget's disease: A multicentre retrospective study of 249 patients |
| title_full |
Therapeutic outcomes and survival analysis of Extramammary Paget's disease: A multicentre retrospective study of 249 patients |
| title_fullStr |
Therapeutic outcomes and survival analysis of Extramammary Paget's disease: A multicentre retrospective study of 249 patients |
| title_full_unstemmed |
Therapeutic outcomes and survival analysis of Extramammary Paget's disease: A multicentre retrospective study of 249 patients |
| title_sort |
Therapeutic outcomes and survival analysis of Extramammary Paget's disease: A multicentre retrospective study of 249 patients |
| dc.creator.none.fl_str_mv |
Escolà, Helena Leal, Lorena Pujol Vallverdú, Ramón M. Deza Vargas, Luis Gustavo |
| author |
Escolà, Helena |
| author_facet |
Escolà, Helena Leal, Lorena Pujol Vallverdú, Ramón M. Deza Vargas, Luis Gustavo |
| author_role |
author |
| author2 |
Leal, Lorena Pujol Vallverdú, Ramón M. Deza Vargas, Luis Gustavo |
| author2_role |
author author author |
| dc.subject.none.fl_str_mv |
Extramammary Paget&apos s disease Mohs micrographic surgery Imiquimod Local recurrence Margin status Radiotherapy |
| topic |
Extramammary Paget&apos s disease Mohs micrographic surgery Imiquimod Local recurrence Margin status Radiotherapy |
| description |
Background: Evidence regarding long-term therapeutic outcomes and disease-specific survival (DSS) in Extramammary Paget's disease (EMPD) is limited. Objectives: To assess the DSS and outcomes of surgical and nonsurgical therapeutic modalities in a large cohort of EMPD patients. Methods: Retrospective chart review of EMPD patients from 20 Spanish tertiary care hospitals. Results: Data on 249 patients with a median follow-up of 60 months were analyzed. The estimated 5-, 10-, and 15-year DSS was 95.9%, 92.9%, and 88.5%, respectively. A significantly lower DSS was observed in patients showing deep dermal invasion (≥1 mm) or metastatic disease (P < .05). A ≥50% reduction in EMPD lesion size was achieved in 100% and 75.3% of patients treated with surgery and topical therapies, respectively. Tumor-free resection margins were obtained in 42.4% of the patients after wide local excision (WLE). The 5-year recurrence-free survival after Mohs micrographic surgery (MMS), WLE with tumor-free margins, WLE with positive margins, radiotherapy, and topical treatments was 63.0%, 51.4%, 20.4%, 30.1%, and 20.8%, respectively. Limitations: Retrospective design. Conclusions: EMPD is usually a chronic condition with favorable prognosis. MMS represents the therapeutic alternative with the greatest efficacy for the disease. Recurrence rates in patients with positive margins after WLE are similar to the ones observed in patients treated with topical agents. |
| publishDate |
2024 |
| dc.date.none.fl_str_mv |
2024 2024 |
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info:eu-repo/semantics/article info:eu-repo/semantics/acceptedVersion |
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article |
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acceptedVersion |
| dc.identifier.none.fl_str_mv |
http://hdl.handle.net/10230/60242 http://dx.doi.org/10.1016/j.jaad.2023.08.088 |
| url |
http://hdl.handle.net/10230/60242 http://dx.doi.org/10.1016/j.jaad.2023.08.088 |
| dc.language.none.fl_str_mv |
Inglés |
| language_invalid_str_mv |
Inglés |
| dc.relation.none.fl_str_mv |
J Am Acad Dermatol. 2024 Jan;90(1):66-73 |
| dc.rights.none.fl_str_mv |
© Elsevier http://dx.doi.org/10.1016/j.jaad.2023.08.088 info:eu-repo/semantics/openAccess |
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© Elsevier http://dx.doi.org/10.1016/j.jaad.2023.08.088 |
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openAccess |
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application/pdf application/pdf |
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Elsevier |
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Elsevier |
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reponame:Recercat. Dipósit de la Recerca de Catalunya instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
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Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
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Recercat. Dipósit de la Recerca de Catalunya |
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Recercat. Dipósit de la Recerca de Catalunya |
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