Objective: To review our experience in diagnosis, pathology, treatment, and prognosis of extramammary Paget's disease of the vulva. Methods: Seven patients with vulvar Paget's disease who were treated at the C...Objective: To review our experience in diagnosis, pathology, treatment, and prognosis of extramammary Paget's disease of the vulva. Methods: Seven patients with vulvar Paget's disease who were treated at the Cancer Hospital cAMS were retrospectively reviewed for the period from 1960 to 2002. The symptoms, location of disease, pathology, mode of treatment and current status of the patients were evaluated. Results: A total of seven women with Paget抯 disease of the vulva were admitted to the Department of Gynecologic of Oncology. The mean age was 67.3 years (range 54~81 years). Vulvar lesion and pruritus were the common symptoms and it took average 3.4 years to confirm the diagnosis. All patients underwent surgery as initial treatment, vulvectomy was performed for 2 patients and radical vulvectomy plus groin node dissection for 5 patients. Two patients had invasive disease and four were associated with underlying adenocarcinoma. Five patients experienced recurrence, on average, 16.2 months after the surgery. Four of them underwent radiotherapy or chemotherapy and the other received no further treatment. The mean follow-up time was 41.1 months. Three patients, with invasive lesion or underlying adenocarcinoma were dead of the disease. Conclusion: There is a delay in the diagnosis of vulvar Paget's disease. The major treatment is surgery. Recurrence is relatively common. Patients with invasive disease or underlying carcinoma have a poor prognosis.展开更多
Objective The aim of the study was to analyze the clinical features of patients with perianal Paget’s disease(PPD)and investigate prognosis risk factors.Methods The SEER*Stat software was used to identify 116 PPD pat...Objective The aim of the study was to analyze the clinical features of patients with perianal Paget’s disease(PPD)and investigate prognosis risk factors.Methods The SEER*Stat software was used to identify 116 PPD patients from 1975 to 2015 in the SEER research database.The Kaplan-Meier method was used to conduct a univariate analysis for PPD patients.The differences in survival rates were evaluated using the log-rank test.The differences in the clinicopathological features of PPD patients with or without anorectal carcinoma were compared using the chi-square test.Results The median survival time of PPD patients was 44 months.The median age of onset was 73 years old.The 43.10%of the patients were alive at the end of follow up,and only 12.93%of the patients died of PPD.Elderly(age>70 years;χ^2=9.453,P=0.002),poor differentiation(χ^2=46.557,P=0.000)and abdominal perineal resection(APR;χ^2=46.557,P=0.000)were unfavorable risk factors of prognosis.Nearly 50%of PPD had combined with other malignancies,and over 22.41%of those had multiple primary neoplasms(3 or more).PPDs predisposed concurrent malignancy,and 48.21%of PPD patients with other malignancies combined with anorectal carcinoma in the study.Stage(χ^2=10.127,P=0.018),and surgical method(χ^2=12.245,P=0.007)were statistically significant in the PPD patients with or without anorectal carcinoma.The 16.07%of patients had multiple lesions of Paget’s.Conclusion Patients with PPD have a favorable survival,while the disease-specific mortality is low.Diagnosed age,differentiation,and surgical methods were the influence factors of prognosis in PPD patients.PPDs with anorectal carcinoma is of most important in further investigation.展开更多
文摘Objective: To review our experience in diagnosis, pathology, treatment, and prognosis of extramammary Paget's disease of the vulva. Methods: Seven patients with vulvar Paget's disease who were treated at the Cancer Hospital cAMS were retrospectively reviewed for the period from 1960 to 2002. The symptoms, location of disease, pathology, mode of treatment and current status of the patients were evaluated. Results: A total of seven women with Paget抯 disease of the vulva were admitted to the Department of Gynecologic of Oncology. The mean age was 67.3 years (range 54~81 years). Vulvar lesion and pruritus were the common symptoms and it took average 3.4 years to confirm the diagnosis. All patients underwent surgery as initial treatment, vulvectomy was performed for 2 patients and radical vulvectomy plus groin node dissection for 5 patients. Two patients had invasive disease and four were associated with underlying adenocarcinoma. Five patients experienced recurrence, on average, 16.2 months after the surgery. Four of them underwent radiotherapy or chemotherapy and the other received no further treatment. The mean follow-up time was 41.1 months. Three patients, with invasive lesion or underlying adenocarcinoma were dead of the disease. Conclusion: There is a delay in the diagnosis of vulvar Paget's disease. The major treatment is surgery. Recurrence is relatively common. Patients with invasive disease or underlying carcinoma have a poor prognosis.
基金Supported by grants from the Scientific Research Staring Foundation for the Returned Overseas Scholars and the Scientific Research Foundation of Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology(No.2019A16)。
文摘Objective The aim of the study was to analyze the clinical features of patients with perianal Paget’s disease(PPD)and investigate prognosis risk factors.Methods The SEER*Stat software was used to identify 116 PPD patients from 1975 to 2015 in the SEER research database.The Kaplan-Meier method was used to conduct a univariate analysis for PPD patients.The differences in survival rates were evaluated using the log-rank test.The differences in the clinicopathological features of PPD patients with or without anorectal carcinoma were compared using the chi-square test.Results The median survival time of PPD patients was 44 months.The median age of onset was 73 years old.The 43.10%of the patients were alive at the end of follow up,and only 12.93%of the patients died of PPD.Elderly(age>70 years;χ^2=9.453,P=0.002),poor differentiation(χ^2=46.557,P=0.000)and abdominal perineal resection(APR;χ^2=46.557,P=0.000)were unfavorable risk factors of prognosis.Nearly 50%of PPD had combined with other malignancies,and over 22.41%of those had multiple primary neoplasms(3 or more).PPDs predisposed concurrent malignancy,and 48.21%of PPD patients with other malignancies combined with anorectal carcinoma in the study.Stage(χ^2=10.127,P=0.018),and surgical method(χ^2=12.245,P=0.007)were statistically significant in the PPD patients with or without anorectal carcinoma.The 16.07%of patients had multiple lesions of Paget’s.Conclusion Patients with PPD have a favorable survival,while the disease-specific mortality is low.Diagnosed age,differentiation,and surgical methods were the influence factors of prognosis in PPD patients.PPDs with anorectal carcinoma is of most important in further investigation.
