The Role of Radiotherapy in Extramammary Paget Disease: A Systematic Review

Tagliaferri, Luca; Casà, Calogero; Macchia, G.; Pesce, Adele; Garganese, Giorgia; Gui, Benedetta; Perotti, Germano; Gentileschi, Stefano; Inzani, Frediano; Autorino, Riccardo; Cammelli, S.; Morganti, Alessio Giuseppe; Valentini, Vincenzo; Gambacorta, M.A.

doi:10.1097/igc.0000000000001237

Cited by 37 publications

(22 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…13,14 Radiotherapy can also be considered a therapeutic option in these cases and/or in patients with multiple relapses. 15 Currently, some studies, mainly case reports, have investigated and documented the effects of conservative topical regimens such as 5-fluorouacil (5-FU), imiquimod and bleomycin, which could decrease the comorbidities associated with both surgery and radiotherapy in patients with PD.…”

Section: Discussionmentioning

confidence: 99%

A Case of Chronic and Relapsing Paget Disease of the Vulva

Bouceiro-Mendes

Mendonça-Sanches

Soares‐de‐Almeida

et al. 2019

Rev Bras Ginecol Obstet

View full text Add to dashboard Cite

Extramammary Paget disease is a rare neoplastic condition that more commonly affects postmenopausal Caucasian women. Although the vulvar area is the most frequently affected location, it corresponds solely to 1 to 2% of all vulvar malignancies. A 72-year-old female patient was observed in our outpatient clinic with a 2-year history of an erythematous and pruritic plaque on the vulva. Histopathology and immunohistochemistry studies were compatible with extramammary Paget disease of the vulva. Associated neoplastic conditions were excluded. Due to multiple relapses, the patient was submitted to three surgical interventions, including a total vulvectomy, and to external radiotherapy. The present case illustrates the chronic and recurrent nature of extramammary Paget disease despite aggressive procedures as well as the challenge in obtaining tumor-free resection margins.

show abstract

Section: Discussionmentioning

confidence: 99%

A Case of Chronic and Relapsing Paget Disease of the Vulva

Bouceiro-Mendes

Mendonça-Sanches

Soares‐de‐Almeida

et al. 2019

Rev Bras Ginecol Obstet

View full text Add to dashboard Cite

show abstract

“…Because of the mutilating surgery, a variety of other therapeutic means have been attempted (8)(9)(10). Radiotherapy alone or associated with chemotherapy remains a treatment option for the relapsing disease (16,17). But the high morbidity of those treatments has stimulated the search for less invasive treatment options such as chemotherapy with intralesional interferon alfa-2b, bleomycin, laser ablation, photodynamic therapy, topical fluorouracil (5-Fu), and imiquimod 5% cream.…”

Section: Discussionmentioning

confidence: 99%

Chronic vulvar Paget’s disease: a therapeutic challenge with a review of the literature

Bouhani¹,

Zemni²,

Fertani³

et al. 2019

JMMS

View full text Add to dashboard Cite

Vulvar Paget's disease is an uncommon adenocarcinoma of the female genital tract, occuring more often in postmenopausal Caucasian women and accounting for 1-2% of all vulvar malignancies. A 39-year-old female patient was examined for the erythematous and pruritic vulvar lesion, with biopsy and histological examination revealing vulvar Paget's disease. We did not diagnose any associated neoplasm. The patient underwent four surgical resections for relapsed disease, varying from local excision to extended excision, including radical vulvectomy, with esthetic coverage. The margins were involved. Due to the extended target volumes, radiotherapy was rejected and the patient underwent a local topical therapy with Imiquimod 5%. The patient was free of disease, with three years of regular follow-ups. This case was challenging due to the long recurrence of the disease for approximately 26 years and due to the therapeutics issues that occurred.

show abstract

“…Vulvar carcinoma is the fourth most common gynecological cancer with an incidence of 1-3 per 100 000 women [1][2][3][4][5][6][7] . The most common histological type of vulvar cancer is squamous cell carcinoma, which accounts for over 80% of cases 8 .…”

Section: Introductionmentioning

confidence: 99%

Ultrasound morphometric and cytologic preoperative assessment of inguinal lymph‐node status in women with vulvar cancer: MorphoNode study

Garganese

Fragomeni

Pasciuto

et al. 2020

Ultrasound in Obstet & Gyne

Self Cite

View full text Add to dashboard Cite

Objective To assess the accuracy of preoperative ultrasound examination for predicting lymph‐node (LN) status in patients with vulvar cancer. Methods This was a single‐institution retrospective observational study of all women with a histological diagnosis of vulvar cancer triaged to inguinal surgery within 30 days following ultrasound evaluation between December 2010 and January 2016. For each groin examined, 15 morphological and dimensional sonographic parameters associated with suspicion for LN involvement were examined. A morphometric ultrasound pattern (MUP) was expressed for each groin, classifying the inguinal LN status into five groups (normal; reactive‐but‐negative; minimally suspicious/probably negative; moderately suspicious; and highly suspicious/positive) according to subjective judgment, followed by stratification as positive or negative for metastasis according to morphometric binomial assessment (MBA). In cases of positive MBA, fine‐needle aspiration cytology was performed. Combining the information obtained from MUP and cytologic results, a binomial final overall assessment (FOA) was assigned for each groin. The final histology was considered as the reference standard. Comparison was performed between patients with negative and those with positive LNs on histology, and receiver‐operating‐characteristics curves were generated for statistically significant variables on univariate analysis, to evaluate their diagnostic ability to predict negative LN status. Results Of 144 patients included in the analysis, 87 had negative inguinal LNs and 57 had positive LNs on histology. A total of 256 groins were analyzed, of which 171 were negative and 85 showed at least one metastatic LN on histology. The following parameters showed the greatest accuracy, with the best balance between specificity and sensitivity, in predicting negative LN status: cortical (C) thickness of the dominant LN (cut‐off, 2.5 mm; sensitivity, 90.0%; specificity, 77.9%); short‐axis (S) length of the dominant LN (cut‐off, 8.4 mm; sensitivity, 63.9%; specificity, 90.6%); C/medulla (M) thickness ratio of the dominant LN (cut‐off, 1.2 mm; sensitivity, 70.4%; specificity, 91.5%), the combination of S length and C/M thickness ratio (sensitivity, 88.9%; specificity, 82.4%); and the FOA analysis (sensitivity, 85.9%; specificity, 84.2%). Conclusions Preoperative ultrasound assessment, with or without the addition of cytology, has a high accuracy in assessing inguinal LN status in patients with vulvar cancer. In particular, the combination of two ultrasound parameters (S length and C/M thickness ratio) provided the greatest accuracy in discriminating between negative and positive LNs. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

show abstract

The Role of Radiotherapy in Extramammary Paget Disease: A Systematic Review

Abstract: To date, literature highlights the role of RT in the management of EMPD, but with low level of evidences.

Cited by 37 publications

References 31 publications

A Case of Chronic and Relapsing Paget Disease of the Vulva

A Case of Chronic and Relapsing Paget Disease of the Vulva

Chronic vulvar Paget’s disease: a therapeutic challenge with a review of the literature

Ultrasound morphometric and cytologic preoperative assessment of inguinal lymph‐node status in women with vulvar cancer: MorphoNode study

Contact Info

Product

Resources

About