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Mohs micrographic surgery for extramammary Paget disease: A pooled analysis of individual patient data

Authors
 Jung Min Bae  ;  Yoon Young Choi  ;  Kee Yang Chung  ;  KyoungAe Nam  ;  Mi Ryung Roh  ;  Byung Ho Oh  ;  Heesu Kim 
Citation
 Journal of the American Academy of Dermatology, Vol.68(4) : 632-637, 2013 
Journal Title
 Journal of the American Academy of Dermatology 
ISSN
 0190-9622 
Issue Date
2013
Abstract
BACKGROUND: Extramammary Paget disease (EMPD) is a rare intraepithelial neoplasm of the skin characterized by ill-defined margins and high recurrence rates after wide local excision. Although Mohs micrographic surgery (MMS) has been proposed to decrease the rate of local recurrence, the efficacy of MMS for this condition has not yet been established. OBJECTIVE: We sought to assess the efficacy of MMS for the treatment of EMPD. METHODS: A comprehensive systematic review and individual patient data meta-analysis was performed including all available clinical studies and case reports with 5 or more subjects describing the use of MMS for EMPD. RESULTS: Eight studies were identified and included in the current review: 3 retrospective studies and 5 case series. In all, 81 patients with 90 cases of MMS were included from these 8 studies. The overall recurrence rate for EMPD after MMS was 12.2% correlating with an estimated 5-year tumor-free rate of 83.6% by using Kaplan-Meier curve analysis. The treatment of EMPD with MMS resulted in significantly lower recurrence rates than wide local excision in this meta-analysis of 3 observational studies with comparators (odds ratio 0.20; 95% confidence interval 0.05-0.81). LIMITATIONS: Limitations include lack of controlled trials, small sample sizes in the included studies, and publication bias. CONCLUSION: The current evidence supports the efficacy of MMS in the treatment of EMPD. Further controlled clinical trials are needed.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86597
DOI
10.1016/j.jaad.2012.12.960
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Dermatology (피부과학교실)
Yonsei Authors
김희수(Kim, Hee Su) ; 노미령(Roh, Mi Ryung) ; 배정민(Bae, Jung Min) ; 오병호(Oh, Byung Ho) ; 정기양(Chung, Kee Yang) ; 최윤영(Choi, Yoon Young)
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Full Text
http://www.sciencedirect.com/science/article/pii/S0190962212023390
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