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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  ;  Heesu Kim  ;  Byung Ho Oh  ;  Mi Ryung Roh  ;  KyoungAe Nam  ;  Kee Yang Chung 
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
MeSH
Humans ; Mohs Surgery* ; Paget Disease, Extramammary/surgery* ; Treatment Outcome
Keywords
extramammary Paget disease ; individual data analysis ; meta-analysis ; Mohs micrographic surgery ; systematic review ; wide local excision
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.
Full Text
http://www.sciencedirect.com/science/article/pii/S0190962212023390
DOI
10.1016/j.jaad.2012.12.960
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Dermatology (피부과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hee Su(김희수)
Roh, Mi Ryung(노미령) ORCID logo https://orcid.org/0000-0002-6285-2490
Bae, Jung Min(배정민)
Oh, Byung Ho(오병호) ORCID logo https://orcid.org/0000-0001-9575-5665
Chung, Kee Yang(정기양) ORCID logo https://orcid.org/0000-0003-3257-0297
Choi, Yoon Young(최윤영) ORCID logo https://orcid.org/0000-0002-2179-7851
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86597
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