Recent treatment and prognosis in 643 patients with extramammary Paget's disease.

Autor: Hatta N; Department of Dermatology, Toyama Prefectural Central Hospital, Toyama, Japan., Ogata D; Department of Dermatology, National Cancer Center Hospital, Tokyo, Japan., Asai J; Department of Dermatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan., Maekawa T; Department of Dermatology, Jichi Medical University, Shimotsuke, Japan., Ito T; Department of Dermatology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan., Takenouchi T; Department of Dermatology, Niigata Cancer Center Hospital, Niigata, Japan., Kiniwa Y; Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan., Miyashita A; Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan., Miyagawa T; Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan., Muto I; Department of Dermatology, Kurume University School of Medicine, Kurume, Japan., Yamamoto Y; Department of Dermatology, Wakayama Medical University, Wakayama, Japan., Nagano T; Department of Dermatology, Kobe City Medical Centre General Hospital, Kobe, Japan., Kiyohara Y; Department of Dermatology, Shizuoka Cancer Center Hospital, Shizuoka, Japan., Nakano E; Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan., Ohe S; Department of Dermatologic Oncology, Osaka International Cancer Institute, Osaka, Japan., Yamaguchi B; Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan., Fukuyama M; Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo, Japan., Matsuya T; Department of Dermatology, Asahikawa Medical University, Asahikawa, Japan., Tsutsumida A; Department of Dermatology, Shizuoka Cancer Center Hospital, Shizuoka, Japan.; Department of Dermatology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan., Namikawa K; Department of Dermatology, National Cancer Center Hospital, Tokyo, Japan., Yamazaki N; Department of Dermatology, National Cancer Center Hospital, Tokyo, Japan.
Jazyk: angličtina
Zdroj: Experimental dermatology [Exp Dermatol] 2024 Feb; Vol. 33 (2), pp. e15030.
DOI: 10.1111/exd.15030
Abstrakt: Information about extramammary Paget's (EMPD) treatment is limited because of the rarity of the disease. The prognosis differs between in situ EMPD and invasive EMPD; therefore, therapy should be planned according to the disease stage. We collected data on 643 EMPD cases treated between 2015 and 2019 in Japan and assessed recent trends in EMPD treatment and prognosis based on the EMPD-oriented TNM staging. Among the 643 patients, 317 had stage 0 (49.3%), 185 had stage I (28.8%), 51 had stage II (7.9%), 18 had stage IIIA (2.8%), 48 had stage IIIB (7.5%) and 24 had stage IV (3.7%) disease. Each stage showed a distinct survival curve, with the exception of stages II and IIIA. Curative surgery was most common in patients with stage 0-III disease. Chemotherapy was the first-line therapy, mainly in patients with stage IIIB and IV disease, most commonly with docetaxel (DTX), followed by DTX + tegafur gimeracil oteracil potassium (TS-1) and TS-1. Patients with local disease exhibited a 4.4% recurrence rate. Univariate analysis revealed no prognostic differences according to age, sex or primary tumour site. SLNB was not related to disease-specific survival. In multivariate analysis, female sex significantly predicted local relapse in stage 0-I (HR 3.09; 95% CI, 1.13-8.43), and initial treatment with curative surgery was significantly protective in terms of disease-specific survival in stage II-IIIA (HR, 0.17; 95% CI, 0.04-0.71) and stage IIIB-IV (HR 0.16; 95% CI, 0.05-0.51). Further clinical studies are needed to improve the prognosis of patients with stage II-IV EMPD.
(© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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