Primary invasive extramammary Paget disease on penoscrotum: a clinicopathological analysis of 41 cases

Shu, Bo; Shen, Xueyan; Chen, Peng; Fang, Xin; Guo, Yonglian; Kong, Yunyi

doi:10.1016/j.humpath.2015.09.005

Cited by 32 publications

(17 citation statements)

References 21 publications

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“…However, results from the multivariate analysis revealed that none of them were associated with cancer-specific survival. These results were consistent with the previous reports1521. Some researchers believe that lymphovascular invasion is an independent predictor for the occult metastasis in clinically node-negative patients, since histological existence of lymphovascular invasion is often recognized far before the clinically visible lymph node metastasis occurs15.…”

Section: Discussionsupporting

confidence: 93%

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Tumor Wide Horizontal Invasion Predicts Local Recurrence for Scrotal Extramammary Paget’s Disease

Wang

Feng

Zhou

et al. 2017

Sci Rep

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Extramammary Paget’s disease (EMPD) is a rare malignancy, and little was known about its prognostic factors and optimal treatment. In the current study, we aimed to discuss clinical and pathological features of scrotal EMPD and determine the prognostic factors for cancer-specific survival and local recurrence. A total of 206 patients with scrotal EMPD lesions surgically treated at our institute were studied. All clinical and pathological data were reviewed. Immunohistochemical staining of TP53 and Ki67 was examined as well. At the last follow-up, 175 patients (84.95%) were alive. Twelve patients (5.83%) had died of the disease due to distant metastases. Fifteen patients (7.28%) developed local recurrences of scrotal EMPD. Ki67 expression was significantly elevated in patients with wide horizontal invasion (P = 0.003). In univariate analysis, high invasion level, presence of nodule, presence of lymphovascular invasion, adnexa invasion, lymph node metastasis and high p53 expression were significant factors for poor cancer-specific survival. In multivariate analysis, high p53 expression was significantly correlated with poor cancer-specific survival. Wide horizontal invasion was independently correlated with local recurrence-free survival of scrotal EMPD. In conclusion, wide horizontal invasion is an independent risk factor for local recurrence-free survival in the patients with scrotal EMPD.

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Section: Discussionsupporting

confidence: 93%

“…In the study of Shu et al ., univariate analysis, delay in diagnosis more than 7.5 years had a significantly shorter cancer-specific survival in invasive penoscrotum EMPD21. In our study, however, delay in diagnosis of scrotal EMPD more than 7 years was neither correlated with cancer-specific survival nor local recurrence-free survival.…”

Section: Discussioncontrasting

confidence: 85%

Tumor Wide Horizontal Invasion Predicts Local Recurrence for Scrotal Extramammary Paget’s Disease

Wang

Feng

Zhou

et al. 2017

Sci Rep

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“…In a recent Japanese study of 301 primary invasive EMPDs (both male and female), 114 (37%) had metastasis including 20% node metastasis and 17% distant metastasis (16% with both nodal and distant metastasis) [12]. Lymph nodes metastasis typically involved inguinofemoral nodes but pelvic and para-aortic nodes were also involved in some patients [9–11, 22, 58–62]. Distant metastatic sites include bone, lung, liver, lung, brain and muscle [9, 58–62].…”

Section: Discussionmentioning

confidence: 99%

GATA3 is a sensitive marker for primary genital extramammary paget disease: an immunohistochemical study of 72 cases with comparison to gross cystic disease fluid protein 15

et al. 2017

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BackgroundGATA-binding protein 3 (GATA3) has been identified as a sensitive marker for breast carcinoma but its sensitivity in primary genital extramammary Paget diseases (EMPDs) has not been well studied.MethodsHere we investigated immunohistochemical expression of GATA3 in 72 primary genital EMPDs (35 from female, 37 from male; 45 with intraepithelial disease only, 26 with both intraepithelial disease and invasive adenocarcinoma including 14 also metastasis, 1 with metastatic adenocarcinoma only for study). We also compared GATA3 to gross cystic disease fluid protein 15 (GCDFP15) for their sensitivity.ResultsPositive GATA3 staining was seen in all 71 (100%) intraepithelial diseases, 25/26 (96%; female 10/10, male 15/16) invasive adenocarcinomas and 14/15 (93%; female 3/3, male 11/12) metastatic adenocarcinomas, respectively. Positive GCDFP15 staining was seen in 46/71 (65%; female 28/34 or 82%, male 18/37 or 49%) intraepithelial diseases, 20/26 (77%; female 9/10, male 11/16) invasive adenocarcinomas, and 12/15 (80%; female 2/3, male 10/12) metastatic adenocarcinomas, respectively (GATA3 versus GCDFP15: p < 0.01 for both intraepithelial disease and invasive adenocarcinoma, p = 0.28 for metastatic adenocarcinoma). In positive-stained cases, GATA3 stained more tumor cells than GCDFP15 (79% versus 25% for intraepithelial disease, 71% vs 34% for invasive adenocarcinoma, 73% vs 50% for metastatic adenocarcinoma, p < 0.01 for all 3 components).ConclusionsOur findings indicate that GATA3 is a very sensitive marker for primary genital EMPDs and is more sensitive than GCDFP15.

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“…[2][3][4][5] Ohara et al 5 reported that among patients with lymph node metastasis, those with two or more lymph node metastases had poorer survival than those with a single lymph node metastasis. [2][3][4][5] Ohara et al 5 reported that among patients with lymph node metastasis, those with two or more lymph node metastases had poorer survival than those with a single lymph node metastasis.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, nodal metastasis has been reported as one of the most important prognostic factors in EMPD. [2][3][4][5] Tumor markers that can indicate disease progression have not yet been established in EMPD due to its rarity. Carcinoembryonic antigen (CEA) has been used as a tumor marker for various adenocarcinomas including EMPD.…”

Section: Introductionmentioning

confidence: 99%

Serum cytokeratin 19 fragment 21‐1 is a useful tumor marker for the assessment of extramammary Paget's disease

Kato

Sumikawa

Hida

et al. 2017

The Journal of Dermatology

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Cytokeratin 19 fragment 21-1 (CYFRA 21-1) has been used as a tumor marker for several malignancies. However, to date, no studies have assessed whether CYFRA 21-1 could be a useful marker for extramammary Paget's disease (EMPD). The present study aimed to evaluate the significance of CYFRA 21-1 as a serum tumor marker for EMPD progression. Concentrations of serum CYFRA 21-1 and carcinoembryonic antigen (CEA) in 13 cases of EMPD were measured prior to undergoing treatment at Sapporo Medical University Hospital from January 2014 to May 2016. Four of the 13 patients had lymph node metastases at diagnosis, but none had distant metastases. Immunohistochemistry indicated that all 13 primary tumors and four metastatic tumors in lymph nodes were positive for cytokeratin 19. Although none of the 13 patients showed high serum CEA levels, six patients (46.2%) had elevated serum CYFRA 21-1. Furthermore, CYFRA 21-1 was reduced in association with post-treatment tumor reduction in all six patients. Among these six patients, four developed recurrence and metastasis during the follow-up period. CYFRA 21-1 was re-elevated in all four of these patients; however, serum CEA was elevated only in the patient with distant metastasis. These results suggest that CYFRA 21-1 is more sensitive compared with CEA, and can be useful as a tumor marker for evaluating tumor progression and treatment efficacy in patients with EMPD.

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Primary invasive extramammary Paget disease on penoscrotum: a clinicopathological analysis of 41 cases

Cited by 32 publications

References 21 publications

Tumor Wide Horizontal Invasion Predicts Local Recurrence for Scrotal Extramammary Paget’s Disease

Tumor Wide Horizontal Invasion Predicts Local Recurrence for Scrotal Extramammary Paget’s Disease

GATA3 is a sensitive marker for primary genital extramammary paget disease: an immunohistochemical study of 72 cases with comparison to gross cystic disease fluid protein 15

Serum cytokeratin 19 fragment 21‐1 is a useful tumor marker for the assessment of extramammary Paget's disease

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