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KMID : 1137020230340060076
Journal of Gynecologic Oncology
2023 Volume.34 No. 6 p.76 ~ p.76
Outcomes and prognostic factors of surgically treated extramammary Paget¡¯s disease of the vulva
Angela Cho

Kim Dae-Yeon
Suh Dae-Shik
Kim Jong-Hyeok
Kim Yong-Man
Kim Young-Tak
Park Jeong-Yeol
Abstract
Objective : Extramammary Paget¡¯s disease (EMPD) of the vulva is a rare disease which predominantly presents in postmenopausal Caucasian women. As yet, no studies on Asian female patients with EMPD have been performed. This study aimed to identify the clinical features of patients with vulvar EMPD in Korea, and to evaluate the risk factors of recurrence and postoperative complications in surgically treated EMPD.

Methods : We retrospectively reviewed 47 patients with vulvar EMPD who underwent wide local excision or radical vulvectomy. The clinical data and surgical and oncological outcomes following surgery were extracted from medical records and analyzed. Univariate and multivariate analyses for predicting recurrence and postoperative complications were performed.

Results : 21.3% of patients had complications after surgery, and wound dehiscence was the most common. 14.9% of patients experienced recurrence, and the median interval to recurrence from initial treatment was 69 (range 33?169) months. Vulvar lesions larger than 40 mm was the independent risk factor of postoperative complications (odds ratio [OR]=7.259; 95% confidence interval [CI]=1.545?34.100; p=0.012). Surgical margin status was not associated with recurrence in surgically treated vulvar EMPD patients (OR=0.83; 95% CI=0.16?4.19; p=1.000).

Conclusion : Positive surgical margin is a frequent finding in the patients with vulvar EMPD, but disease recurrence is not related with surgical margin status. Since EMPD is a slow growing tumor, a surveillance period longer than 5 years is required.
KEYWORD
Vulvar disease, Vulvar neoplasm, Surgical margin
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