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Initial topical monotherapy may increase the risk of recurrence in patients with extramammary Paget's disease

Authors
 Sooyie Choi  ;  Yeongjoo Oh  ;  Mi Ryung Roh  ;  Kee Yang Chung  ;  Byung Ho Oh 
Citation
 JOURNAL OF DERMATOLOGY, Vol.48(5) : 585-591, 2021-05 
Journal Title
 JOURNAL OF DERMATOLOGY 
ISSN
 0385-2407 
Issue Date
2021-05
MeSH
Fluorouracil ; Humans ; Imiquimod ; Neoplasm Recurrence, Local / drug therapy ; Paget Disease, Extramammary* / drug therapy ; Retrospective Studies
Keywords
Mohs micrographic surgery ; extramammary Paget's disease ; prognosis ; recurrence ; topical
Abstract
Although topical therapies are used to treat extramammary Paget's disease (EMPD), reliable treatment outcomes and the effects of these therapies on subsequent surgical treatments are unclear. To assess the clinical outcomes of topical treatment of EMPD and establish the treatment guidelines the medical records of 166 patients diagnosed with EMPD were retrospectively reviewed. The recurrence rate was evaluated according to the previous use of topical agents. Thirty-four patients (34/166, 20.5%) were initially treated with topical agents such as imiquimod, 5-fluorouracil, and ingenol mebutate. Three patients (3/34, 8.8%) showed clinical response, while 31 patients required subsequent therapy owing to treatment failure. Analysis of the prognostic factors of recurrence in 166 patients revealed that initial topical treatment increased the hazard ratio (HR) in both univariate and multiple Cox proportional hazards models (HR = 3.770, 95% confidence interval [CI] = 1.768-8.037, P = 0.001, and adjusted HR = 3.628, 95% CI = 1.558-8.450, P = 0.003). Patients treated with topical agents showed significantly poorer 3-year recurrence-free survival than the nontreated group (66.3% vs 88.6%, P < 0.001). Topical treatment may be deleterious for some EMPD patients, thus increasing the recurrence risk.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/1346-8138.15794
DOI
10.1111/1346-8138.15794
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Dermatology (피부과학교실) > 1. Journal Papers
Yonsei Authors
Roh, Mi Ryung(노미령) ORCID logo https://orcid.org/0000-0002-6285-2490
Oh, Byung Ho(오병호) ORCID logo https://orcid.org/0000-0001-9575-5665
Oh, Yeongjoo(오영주) ORCID logo https://orcid.org/0000-0003-4973-9335
Chung, Kee Yang(정기양) ORCID logo https://orcid.org/0000-0003-3257-0297
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182882
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