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经皮穿刺活检在阴茎阴囊部外 Paget 病治疗中的作用。

Usefulness of Mapping Biopsy in the Treatment of Penoscrotal Extramammary Paget's Disease.

机构信息

Department of Plastic and Reconstructive Surgery, Research Institute of Plastic and Reconstructive Surgery, Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul, Korea.

Department of Plastic and Reconstructive Surgery, Dongguk University Medical Center, Goyang, Korea.

出版信息

Ann Surg Oncol. 2017 Oct;24(11):3229-3236. doi: 10.1245/s10434-017-5947-7. Epub 2017 Jun 26.

Abstract

BACKGROUND

Extramammary Paget's disease (EMPD) is a rare cutaneous malignancy; however, the standard treatment of EMPD has not been established. In this study, we applied mapping biopsy to penoscrotal EMPD and evaluated its effects.

METHODS

A retrospective chart review was performed to determine the outcomes of patients with primary penoscrotal EMPD who underwent surgery at our institution between 2007 and 2014. Patients were divided into two groups (one group underwent mapping biopsy, while the other group did not), and the difference between the two groups was analyzed. The 5-year tumor-free rate was estimated using the Kaplan-Meier method, and the risk factors for local recurrence were also estimated.

RESULTS

A total of 44 patients were analyzed, and the mean follow-up of patients was 50.27 months. Patients who underwent mapping biopsy showed significantly lower tumor involvement at permanent and frozen biopsies and a lower local recurrence rate than those who did not undergo mapping biopsy. The 5-year tumor-free rate was significantly higher in the mapping biopsy group than in the non-mapping biopsy group. Multivariable analysis demonstrated that age at operation, mapping biopsy, and false-negative results at frozen biopsy were associated with local recurrence.

CONCLUSIONS

Mapping biopsy is beneficial to reduce local recurrence in penoscrotal EMPD.

摘要

背景

乳房外 Paget 病(EMPD)是一种罕见的皮肤恶性肿瘤,但 EMPD 的标准治疗方法尚未确立。在本研究中,我们对阴囊 EMPD 采用了定位活检,并评估了其效果。

方法

对 2007 年至 2014 年间在我院接受手术治疗的原发性阴囊 EMPD 患者的病历进行回顾性分析。患者分为两组(一组行定位活检,另一组不行),并对两组进行分析。采用 Kaplan-Meier 法估计 5 年无瘤生存率,同时还估计了局部复发的危险因素。

结果

共分析了 44 例患者,患者的平均随访时间为 50.27 个月。与未行定位活检的患者相比,行定位活检的患者在永久性和冷冻活检中肿瘤受累程度明显较低,局部复发率也较低。定位活检组的 5 年无瘤生存率明显高于非定位活检组。多变量分析表明,手术时的年龄、定位活检和冷冻活检的假阴性结果与局部复发有关。

结论

定位活检有助于降低阴囊 EMPD 的局部复发率。

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