[Genital Paget's disease].

This is a review of 68 cases of genital Paget's disease (47 male, 17 female) and 4 cases of perianal Paget's disease (3 male, 1 female) encountered over the past 30 years (1958-1987). The age distribution was 52 to 86 years, 68.9 in average, in male patients, and 51 to 80 years, 64.4 in average, in females. By sex difference, the male subjects were predominant at 2.8:1. We classified the patients into the following stages. Stage I was considered to be when Paget's lesion was noted only intraepidermally or in the skin adnexa, stage II when dermal invasion of medium degree was noted or when intraepidermal invasion was found in the urethral or vaginal mucosa, stage III when dermal invasion of higher degree was noted or when metastasis was observed in the regional lymph node, and stage IV when remote metastasis was recognized. For patients in stage I or II, we performed 1) wide local excision and 2) split-thickness skin graft, occasionally with prophylactic node dissection. For stage III, radical node dissection was added to 1) and 2). In stage IV, mainly immunochemotherapy was applied. As the prognosis, the 5-year surival rate was 100% in stage I (n = 53), lower in stage II (n = 6) or III (n = 7), while in stage IV the 3-year survival rate was 0% (n = 6).