Usefulness of sentinel lymph node biopsy for extramammary Paget disease

Nakamura, Yoshiyuki; Fujisawa, Yasuhiro; Ishikawa, Masashi; Ishitsuka, Yosuke; Maruyama, Hiroshi; Furuta, Junichi; Kawachi, Yasuhiro; Otsuka, Fujio

doi:10.1111/j.1365-2133.2012.11017.x

Cited by 34 publications

(43 citation statements)

References 10 publications

(13 reference statements)

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“…It goes without saying that intraepithelial tumors have no chance of metastasis, and SLNB is unnecessary for them. Previous reports did not find a correlation between lymphadenopathy and death [1] or SLN positivity [3,4] in iEMPD. Accordingly, they suggested that SLN biopsy should be applied regardless of the presence or absence of lymphadenopathy [3,12].…”

Section: Discussionmentioning

confidence: 54%

“…Several reports indicated that SLN biopsy might be useful in the management of EMPD [1,3,4]. However, the previous studies included relatively few patients, and these studies included not only patients with intraepithelial tumors but also lymphadenopathy.…”

Section: Discussionmentioning

confidence: 99%

“…However, we sometimes encounter patients with invasive EMPD (iEMPD) that may cause lymph node (LN) metastasis [1] and lead to the development of distant metastasis [2]. Prognosis is reported to be poor not only in patients with distant metastasis, but also in patients with bilateral regional LN metastases [1] and multiple LN metastases in the same region [3]. Since chemotherapy is considered ineffective for the iEMPD patients with disseminated disease [1], it has been critical to detect LN metastasis at an early stage and prevent further development.…”

Section: Introductionmentioning

confidence: 99%

“…Considering the morbidity associated with LN dissection, Hatta et al [4] suggested the use of sentinel LN biopsy (SLNB) in EMPD, which has become the standard care in other cancers such as melanoma [5] and breast cancer [6] to find the patients who need LN dissection. Subsequently, several investigators reported the usefulness of SLNB in the management of EMPD [3,[7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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The role of sentinel lymph node biopsy in the management of invasive extramammary Paget's disease: Multi-center, retrospective study of 151 patients

Fujisawa

Yoshino

Kiyohara

et al. 2015

Journal of Dermatological Science

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The role of sentinel lymph node biopsy in the management of invasive extramammary Paget's disease: Multi-center, retrospective study of 151 patients

Fujisawa

Yoshino

Kiyohara

et al. 2015

Journal of Dermatological Science

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“…Nakamura et al 47 described 27 cases in which the incidence of sentinel lymph node metastasis was 37%. Lymph node metastasis occurred in 60% of tumours with microinvasion and in 44% with dermal invasion.…”

Section: 21mentioning

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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Anatomic Subtype Differences in Extramammary Paget Disease

Kibbi,

Owen,

Worley

et al. 2024

JAMA Dermatol

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ImportanceExtramammary Paget disease (EMPD) is a rare, highly recurrent cutaneous malignant neoplasm of unclear origin. EMPD arises most commonly on the vulvar and penoscrotal skin. It is not presently known how anatomic subtype of EMPD affects disease presentation and management.ObjectiveTo compare demographic and tumor characteristics and treatment approaches for different EMPD subtypes. Recommendations for diagnosis and treatment are presented.Data SourcesMEDLINE, Embase, Web of Science Core Collection, and Cochrane Reviews CENTRAL from December 1, 1990, to October 24, 2022.Study SelectionArticles were excluded if they were not in English, reported fewer than 3 patients, did not specify information by anatomic subtype, or contained no case-level data. Metastatic cases on presentation were also excluded.Data Extraction and SynthesisAbstracts of 1295 eligible articles were independently reviewed by 5 coauthors, and 135 articles retained. Reporting was in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. The analysis was cunducted in August 2019 and updated in November 2022.FindingsMost vulvar EMPD cases were asymptomatic, and diagnosis was relatively delayed (mean, 25.1 months). Although most vulvar EMPD cases were intraepidermal (1247/1773 [70.3%]), radical surgeries were still performed in almost one-third of cases. Despite this aggressive surgical approach, 481 of 1423 (34%) recurred, commonly confined to the skin and mucosa (177/198 [89.4%]). By contrast, 152 of 1101 penoscrotal EMPD cases (14%) recurred, but more than one-third of these recurrences were regional or associated with distant metastases (54 of 152 [35.5%]). Perianal EMPD cases recurred in one-third of cases (74/218 [33.9%]), with one-third of these recurrences being regional or associated with distant metastasis (20 of 74 [27.0%]). Perianal EMPD also had the highest rate of invasive disease (50% of cases).Conclusions and RelevanceThe diagnosis and treatment of EMPD should differ based on anatomic subtypes. Considerations for updated practice may include less morbid treatments for vulvar EMPD, which is primarily epidermal, and close surveillance for local recurrence in vulvar EMPD and metastatic recurrence in perianal EMPD. Recurrences in penoscrotal subtype were less common, and selective surveillance in this subtype may be considered. Limitations of this study include the lack of replication cohorts and the exclusion of studies that did not stratify outcomes by anatomic subtype.

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Usefulness of sentinel lymph node biopsy for extramammary Paget disease

Cited by 34 publications

References 10 publications

The role of sentinel lymph node biopsy in the management of invasive extramammary Paget's disease: Multi-center, retrospective study of 151 patients

The role of sentinel lymph node biopsy in the management of invasive extramammary Paget's disease: Multi-center, retrospective study of 151 patients

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

Anatomic Subtype Differences in Extramammary Paget Disease

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