Comparison of wide local excision and radical excision for Paget’s disease involving the penis and scrotum_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

MENG Fanjun , PU Yi , CHEN Zhixing ,  CEN Ying ,  CHEN Junjie

Department of Burns and Plastic Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;

Corresponding?author：

CEN Ying, Email: Cenying0141@163.com; CHEN Junjie, Email: cjjemail@163.com

Keywords：

Paget’s disease involving penis and scrotum; wide local excision; radical resection; recurrence rate

DOI：

10.7507/1002-1892.201701070

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the effectiveness and advantages of the wide local excision for Paget’s disease involing the penis and scrotum by comparing with the radical excision. Methods A retrospective analysis was made on the clinical data of 41 patients with Paget’s disease involving penis and scrotum who met the inclusion criteria between November 2010 and August 2015. Among them, 14 patients received wide local excision (group A), and 27 patients received radical excision (group B). No significant difference was found in age, course of disease, and lesion site between two groups (P>0.05). The recurrence rate, operative time, times of intraoperative frozen section pathology, hospitalization time, grade of wound healing, appearance and functions satisfaction were recorded and compared between two groups. Results The operative time and hospitalization time in group A were significantly shorter than those in group B (P<0.05); the times of intraoperative frozen section pathology in group A were significantly less than that in group B (P<0.05). All patients were followed up 13 to 67 months (mean, 35.5 months) in group A and 11 to 70 months (mean, 38.8 months) in group B. Grades A, B, and C wound healing was obtained in 11 cases, 2 cases, and 1 case of group A and in 12 cases, 7 cases, and 8 cases of group B respectively, showing significant difference between two groups (Z=–2.102, P=0.036). The 5-year recurrence rate was 28.6% (4/14) in group A and 22.2% (6/27) in group B, showing no significant difference (χ²=0.202, P=0.654). The score of satisfaction in appearance and functions in group A was significantly higher than that in group B (t=–2.810, P=0.008). Conclusion Paget’s disease involving penis and scrotum has a slow disease progression and good prognosis. Wide local excision can relieve symptoms effectively and obviously decrease perioperative risk in elderly patients, with no significant increase of the recurrence rate.

Citation： MENG Fanjun, PU Yi, CHEN Zhixing, CEN Ying, CHEN Junjie. Comparison of wide local excision and radical excision for Paget’s disease involving the penis and scrotum. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(6): 714-717. doi: 10.7507/1002-1892.201701070 Copy

1.	Black D, Tornos C, Soslow RA, et al. The outcomes of patients with positive margins after excision for intraepithelial Paget’s disease of the vulva. Gynecologic Oncology, 2007, 104(3): 547-550.
2.	Jeon MS, Jung GY, Lee JH, et al. Extramammary Paget disease of the vulva: minimal excision with adjuvant radiation treatment for optimal aesthetic results. Tumori, 2016, 102(Suppl 2): doi: 10.5301/tj.5000394.
3.	Lee KY, Roh MR, Chung WG, et al. Comparison of Mohs micrographic surgery and wide excision for extramammary Paget’s disease: Korean experience. Dermatol Surg, 2008, 35(1):34-40.
4.	劉穎, 張新華, 余波,等. 30 例乳腺外 Paget 病的臨床病理及預后分析. 臨床與實驗病理學雜志, 2014, 30(11): 1211-1214.
5.	Kang Z, Zhang Q, Zhang Q, et al. Clinical and pathological characteristics of extramammary Paget’s disease: report of 246 Chinese male patients. Int J Clin Exp Pathol, 2015, 8(10): 13233-13240.
6.	Hatta N, Yamada M, Hirano T, et al. Extramammary Paget’s disease: treatment, prognostic factors and outcome in 76 patients. Br J Dermatol, 2008, 158(2): 313-318.
7.	Shiomi T, Yoshida Y, Yamamoto O, et al. Original paper Extramammary Paget’s disease: evaluation of the adnexal status of 53 cases. Polish Journal of Pathology, 2015, 66(2): 121-126.
8.	Cohen JM, Granter SR, Werchniak AE. Risk stratification in extramammary Paget disease. Clin Exp Dermatol, 2015, 40(5): 473-478.
9.	Ogata D, Kiyohara Y, Yoshikawa S, et al. Usefulness of sentinel lymph node biopsy for prognostic prediction in extramammary Paget’s disease. Eur J Dermatol, 2016, 26(3): 254-259.
10.	Fujisawa Y, Yoshino K, Kiyohara Y, et al. The role of sentinel lymph node biopsy in the management of invasive extramammary Paget’s disease: Multi-center, retrospective study of 151 patients. J Dermatol Sci, 2015, 79(1): 38-42.
11.	郭亮儂, 劉小青, 李航,等. 乳房外 Paget 病 75 例臨床病理特點分析. 中華醫學雜志, 2015, 95(22): 1751-1754.
12.	Murata T, Honda T, Egawa G, et al. Three-dimensional evaluation of subclinical extension of extramammary Paget’s disease: Visualization of histological border and its comparison to clinical border. Br J Dermatol, 2016. [Epub ahead of print].
13.	Shiomi T, Yoshida Y, Shomori K, et al. Extramammary Paget’s disease: evaluation of the histopathological patterns of Paget cell proliferation in the epidermis. J Dermatol, 2011, 38(11): 1054-1057.
14.	Herrel LA, Weiss AD, Goodman M, et al. Extramammary Paget’s disease in males: survival outcomes in 495 patients. Ann Surg Oncol, 2015, 22(5): 1625-1630.
15.	劉斌, 于東風, 常家聰, 等. 高齡賁門癌患者的臨床特點及外科治療的探討. 中華普通外科雜志, 2002, 17(8): 461-462.
16.	趙平, 唐令超, 丁志, 等. 超高齡與其他年齡組胃癌患者手術治療的對比分析. 中國腫瘤臨床與康復, 2013, 20(2): 128-130.
17.	史繼榮, 劉斯, 趙建勛. 75 歲以上高齡患者的外科決策——附 133 例病例報告. 中國現代醫學雜志, 2007, 17(15): 1853-1855.
18.	卿勇, 岑瑛, 劉曉雪, 等. 會陰部 Paget’s 病的外科治療. 中國修復重建外科雜志, 2007, 21(11): 1213-1215.

1. Black D, Tornos C, Soslow RA, et al. The outcomes of patients with positive margins after excision for intraepithelial Paget’s disease of the vulva. Gynecologic Oncology, 2007, 104(3): 547-550.
2. Jeon MS, Jung GY, Lee JH, et al. Extramammary Paget disease of the vulva: minimal excision with adjuvant radiation treatment for optimal aesthetic results. Tumori, 2016, 102(Suppl 2): doi: 10.5301/tj.5000394.
3. Lee KY, Roh MR, Chung WG, et al. Comparison of Mohs micrographic surgery and wide excision for extramammary Paget’s disease: Korean experience. Dermatol Surg, 2008, 35(1):34-40.
4. 劉穎, 張新華, 余波,等. 30 例乳腺外 Paget 病的臨床病理及預后分析. 臨床與實驗病理學雜志, 2014, 30(11): 1211-1214.
5. Kang Z, Zhang Q, Zhang Q, et al. Clinical and pathological characteristics of extramammary Paget’s disease: report of 246 Chinese male patients. Int J Clin Exp Pathol, 2015, 8(10): 13233-13240.
6. Hatta N, Yamada M, Hirano T, et al. Extramammary Paget’s disease: treatment, prognostic factors and outcome in 76 patients. Br J Dermatol, 2008, 158(2): 313-318.
7. Shiomi T, Yoshida Y, Yamamoto O, et al. Original paper Extramammary Paget’s disease: evaluation of the adnexal status of 53 cases. Polish Journal of Pathology, 2015, 66(2): 121-126.
8. Cohen JM, Granter SR, Werchniak AE. Risk stratification in extramammary Paget disease. Clin Exp Dermatol, 2015, 40(5): 473-478.
9. Ogata D, Kiyohara Y, Yoshikawa S, et al. Usefulness of sentinel lymph node biopsy for prognostic prediction in extramammary Paget’s disease. Eur J Dermatol, 2016, 26(3): 254-259.
10. Fujisawa Y, Yoshino K, Kiyohara Y, et al. The role of sentinel lymph node biopsy in the management of invasive extramammary Paget’s disease: Multi-center, retrospective study of 151 patients. J Dermatol Sci, 2015, 79(1): 38-42.
11. 郭亮儂, 劉小青, 李航,等. 乳房外 Paget 病 75 例臨床病理特點分析. 中華醫學雜志, 2015, 95(22): 1751-1754.
12. Murata T, Honda T, Egawa G, et al. Three-dimensional evaluation of subclinical extension of extramammary Paget’s disease: Visualization of histological border and its comparison to clinical border. Br J Dermatol, 2016. [Epub ahead of print].
13. Shiomi T, Yoshida Y, Shomori K, et al. Extramammary Paget’s disease: evaluation of the histopathological patterns of Paget cell proliferation in the epidermis. J Dermatol, 2011, 38(11): 1054-1057.
14. Herrel LA, Weiss AD, Goodman M, et al. Extramammary Paget’s disease in males: survival outcomes in 495 patients. Ann Surg Oncol, 2015, 22(5): 1625-1630.
15. 劉斌, 于東風, 常家聰, 等. 高齡賁門癌患者的臨床特點及外科治療的探討. 中華普通外科雜志, 2002, 17(8): 461-462.
16. 趙平, 唐令超, 丁志, 等. 超高齡與其他年齡組胃癌患者手術治療的對比分析. 中國腫瘤臨床與康復, 2013, 20(2): 128-130.
17. 史繼榮, 劉斯, 趙建勛. 75 歲以上高齡患者的外科決策——附 133 例病例報告. 中國現代醫學雜志, 2007, 17(15): 1853-1855.
18. 卿勇, 岑瑛, 劉曉雪, 等. 會陰部 Paget’s 病的外科治療. 中國修復重建外科雜志, 2007, 21(11): 1213-1215.

Chinese Journal of Reparative and Reconstructive Surgery

Comparison of wide local excision and radical excision for Paget’s disease involving the penis and scrotum

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content