Intraoperative Immunostaining for Cytokeratin-7 During Mohs Micrographic Surgery Demonstrates Low Local Recurrence Rates in Extramammary Paget's Disease
| Autor: | David G. Brodland, Mark A. Cappel, John A. Zitelli, Mario Mitkov, Ali Alexander Damavandy, Ali Hendi, Thuzar M. Shin, Christopher J. Miller, Vitaly Terushkin, Jeremy R. Etzkorn |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Skin Neoplasms medicine.medical_treatment Dermatology Malignancy Extramammary Paget's disease 030207 dermatology & venereal diseases 03 medical and health sciences Cytokeratin 0302 clinical medicine Mohs surgery Humans Medicine Aged Retrospective Studies Aged 80 and over Intraoperative Care business.industry Keratin-7 fungi Retrospective cohort study General Medicine Middle Aged Mohs Surgery medicine.disease Immunohistochemistry Cross-Sectional Studies Paget Disease Extramammary 030220 oncology & carcinogenesis Keratin 7 Female Surgery Radiology Neoplasm Recurrence Local business Immunostaining |
| Zdroj: | Dermatologic Surgery. 44:354-364 |
| ISSN: | 1524-4725 1076-0512 |
| DOI: | 10.1097/dss.0000000000001355 |
| Popis: | Background Extramammary Paget's disease (EMPD) is a rare intraepithelial malignancy with high recurrence rates following standard surgical treatments, ranging from 22% to 60% in large retrospective reviews. Objective To evaluate the local recurrence rate of Mohs micrographic surgery (MMS) supplemented with intraoperative immunohistochemistry for cytokeratin-7 (MMS + CK-7) for primary and recurrent EMPD. Materials and methods Retrospective, multi-center, cross-sectional study of patients treated using MMS + CK-7. Demographic, clinicopathologic, treatment, and follow-up data were obtained by chart review. Results The observed local recurrence rate for MMS + CK-7 is 3.3% (2/61 tumors) with a mean follow-up of 43.5 months (1-120 months). Local recurrence occurred in 2.3% (1/43) of primary tumors and 5.6% (1/18) of recurrent tumors. Kaplan-Meier 5-year tumor-free rates are 94.6% overall, 97.1% for primary tumors, and 80.0% for recurrent tumors. The Kaplan-Meier 5-year tumor-free rates for all EMPD tumors treated with MMS + CK-7 versus a historical cohort of MMS alone are 94.6% versus 72.0% (p = .012). Conclusion MMS + CK-7 is an effective treatment for EMPD, demonstrating improved outcomes compared with historical controls. |
| Databáze: | OpenAIRE |
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