Factors Related to Recurrence Rates of Extramammary Paget Disease: A Case Series and Literature Review

Abstract

Extramammary Paget disease (EMPD) is a rare cutaneous malignant lesion. Surgical resection is the primary treatment. However, the ideal surgical margin remains uncertain. This study aimed to investigate the correlation between different margins and EMPD recurrence rates. A total of 35 EMPD patients underwent surgical resection between 2008 and 2018. This study considered multiple factors associated with the local recurrence rate, including surgical margin, depth of excision, pathological margin, tumor size, and the time until recurrence occurred. The study demonstrated that a surgical margin of 2 cm signified the outcome of local recurrence, with 20.8% in the <2 cm group and no local recurrence (0.0%) in the ≥2 cm group (p = 0.157). The tumor size statistics significantly affected the local recurrence at 9 cm (p < 0.05). Other managements had no statistical significance to the local recurrence rate. A surgical margin size of more than 2 cm is suggested for the wide excision of EMPD patients, considering the recurrence percentage and outcome in this study. This retrospective study aimed to find the relation of surgical margin and the disease outcome of extramammary Paget disease (EMPD) by considering multiple factors associated with the local recurrence rate, including surgical margin, depth of excision, pathological margin, tumor size, and the time until recurrence occurred. The result showed that a surgical margin of ≥2 cm gave a better outcome of disease, and a tumor larger than 9 cm significantly affected the recurrence rate. The study suggests surgical excision of more than 2 cm around the tumor.