Role of Radiotherapy as Curative Treatment of Extramammary Paget’s Disease

Hata, Masaharu; Omura, Motoko; Koike, Izumi; Wada, Hidefumi; Miyagi, Etsuko; Tayama, Yoshibumi; Odagiri, Kazumasa; Minagawa, Y.; Ogino, Ichiro; Inoue, Tomio

doi:10.1016/j.ijrobp.2010.01.073

Cited by 41 publications

(49 citation statements)

References 48 publications

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“…This data was collected by searching English-language journals included in the PubMed database and published between 1991 and 2012, using the keywords ‘EMPD' and ‘radiotherapy'. 15 available articles were identified [15,16,17,18,19,20,21,22,24,25,26,27,28,29,30]; however, 1 article [30] was excluded from this analysis because the applied radiotherapy methods were not described in detail. Therefore, 66 patients (21 male, 45 female; median age 73 years (range 38-92 years)) from 14 articles were analyzed (table 3).…”

Section: Methodsmentioning

confidence: 99%

“…The median irradiated dose was 60 Gy (range 45-70.2 Gy); the median daily dose was 3.0 Gy (range 1.7-10 Gy). 22 patients from 1 article [26] were unavailable for calculation of a Kaplan-Meier curve; however, data from 41 patients from 13 articles were available. We used the Kaplan-Meier method to analyze local progression-free survival, locoregional progression-free survival, and overall survival, alone and combined with PubMed-derived data.…”

Section: Methodsmentioning

confidence: 99%

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Radiotherapy in Patients with Extramammary Paget's Disease - Our Own Experience and Review of the Literature

et al. 2014

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Background: There are few reports on radiotherapy methods for treating extramammary Paget's disease (EMPD). The aim of this study was to explore the outcome of radiotherapy for EMPD. Patients and Methods: Between June 1995 and October 2010, 14 patients with EMPD (7 male and 7 female; median age 77 years) underwent radiotherapy at the Tokyo Medical University Hospital. The median total irradiation dose was 50 Gy, delivered in 20-33 fractions. Case reports of patients with EMPD were obtained from the PubMed database for the period of 1991-2012. 66 patients (median age 73 years) were identified. Radiotherapy outcomes were analyzed. Results: All patients achieved complete response within the irradiated volume during a median observation period of 71.4 months. The 5-year locoregional progression-free survival and overall survival were 91.7% (95% confidence interval (CI) 53.9-98.8%) and 84.3% (95% CI 50.3-95.8%), respectively. From the PubMed database, the 5-year local progression-free survival and locoregional progression-free survival were 84.5% (95% CI 65.3-93.6%) and 77.5% (95% CI 57.3-89.0%), respectively. 12 (18%) patients had a recurrence in the inguinal lymph nodes. Conclusion: Radiotherapy yielded good local control and survival, which suggests that it was effective for patients with EMPD and in particular medically inoperable EMPD.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Radiotherapy in Patients with Extramammary Paget's Disease - Our Own Experience and Review of the Literature

et al. 2014

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“…For example, a recent seer analysis did not show an extra survival benefit with the addition of adjuvant radiotherapy after surgery 5 ; however, patients who received radiotherapy might have been high-risk patients who were not candidates for surgery or who were at high risk of local recurrence. However, to reduce local recurrences, adjuvant radiotherapy has been used in patients who are at high risk for recurrence postoperatively or who had positive margins at surgery [48][49][50][51][52][53][54] .…”

Section: 22mentioning

confidence: 99%

“…Some publications report complete regression of carcinoma in situ empd after definitive radiotherapy 55 . Traditionally, radiation doses of 45 Gy-70 Gy have been prescribed in both the definitive and adjuvant settings [48][49][50][51][52][53][54]56 . Various radiation techniques have been used, including megavoltage and orthovoltage photon therapy, electron-beam therapy, and highdose-rate mould brachytherapy 50 .…”

Section: 22mentioning

confidence: 99%

Management of Penoscrotal Extramammary Paget Disease: Case Series and Review of the Literature

et al. 2013

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The medical literature available to guide the management of empd is limited, particularly for metastatic disease. Another challenge is to differentiate metastatic empd from a concurrent invasive cancer. Here, we present our case series of 6 patients with empd of the penoscrotal region, our experience with systemic therapy, and a literature review for this rare malignancy. METHODSWe identified 6 cases of penoscrotal empd treated at The Ottawa Hospital from 2007 to 2012. All cases underwent pathology review. After research ethics board approval, clinical and demographic data, including age at presentation, presence of a second malignancy, management, and follow-up were collected from patient records. The literature was reviewed for clinical and pathologic features, treatment options, and outcomes. RESULTS 3

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“…Hata reported that radiotherapy was a curative therapy in 22 patients with EMPD. 18 Photodynamic therapy is believed by some authors to be effective. [19][20] Imiquimod 5% cream was successfully used in two series.…”

Section: Complicationsmentioning

confidence: 99%

Penoscrotal extramammary Paget's disease: surgical techniques and follow-up experiences with thirty patients

Chen¹,

Chen²,

Wang³

et al. 2013

Asian J Androl

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To report the surgical management, complications and prognosis of patients with penoscrotal extramammary Paget's disease (EMPD) at different clinical stages. Between 2003 and 2008, a total of 30 male patients with penoscrotal EMPD were enrolled and evaluated. All enrolled subjects received frozen biopsy-guided local wide resection and immediate reconstruction. Patients were followed every 3 months postoperatively. Among the 30 patients who accepted and underwent frozen biopsy-guided local wide resection treatment and reconstruction, two (6.7%) cases exhibited positive margins, verified by pathological examination, and underwent re-excision after surgery. The technique of primary closure or an adjacent flap was used in 10 (33.3%) cases, split-thickness skin grafts were used in 15 (50%), and an anterolateral thigh perforator flap was used in five cases (16.7%). The postoperative complications were acceptable. The mean follow-up time was 64.9629.6 months. Of all 30 cases, 22 patients (73.3%) survived with no evidence of recurrence, four patients (13.3%) exhibited local recurrence, two patients (6.7%) exhibited both local recurrence and distant metastasis and the remaining two patients (6.7%) exhibited distant metastasis. Five patients died from metastasis or cachexia. Current surgical techniques, including primary closure, adjacent flaps, split-thickness skin flaps and anterolateral thigh perforator flaps are able to reconstruct all types of defects with acceptable complications. Some patients with negative margins went on to exhibit local recurrence, potentially due to adnexal carcinoma or internal malignancy.

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Role of Radiotherapy as Curative Treatment of Extramammary Paget’s Disease

Cited by 41 publications

References 48 publications

Radiotherapy in Patients with Extramammary Paget's Disease - Our Own Experience and Review of the Literature

Radiotherapy in Patients with Extramammary Paget's Disease - Our Own Experience and Review of the Literature

Management of Penoscrotal Extramammary Paget Disease: Case Series and Review of the Literature

Penoscrotal extramammary Paget's disease: surgical techniques and follow-up experiences with thirty patients

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