Invasive Paget Disease of the Vulva

Int J Gynecol Cancer. 2018 Jan;28(1):176-182. doi: 10.1097/IGC.0000000000001131.

Abstract

Objective: Extramammary Paget disease of the vulva (EPDV) is a rare occurrence with an indolent and relapsing course. Progression to invasion occurs in 4% to 19% of cases. The aim of this study is to report clinical-pathological features and outcomes of patients treated for invasive EPDV.

Methods: Data of consecutive patients treated between 2000 and 2017 for invasive EPDV were reviewed.

Results: Among 79 patients with EPDV, 10 (12.7%) presented a microinvasive or invasive form at first diagnosis or during follow-up. All of them underwent upfront radical surgery; 7 (70%) received subsequent radiotherapy, chemotherapy, or both. The mortality rate was 40%. The recurrence rate after treatment for invasive forms was 60%, with a mean time to first recurrence of 20 (range, 5-36) months.

Conclusions: Our study confirms that invasive EPDV remains a rare gynecological neoplasm with a poor prognosis. Multicentre trials or well-organized prospective data collection could improve the knowledge about the management of invasive EPDV.

MeSH terms

  • Aged
  • Chemoradiotherapy, Adjuvant
  • Chemotherapy, Adjuvant
  • Female
  • Humans
  • Middle Aged
  • Paget Disease, Extramammary / pathology*
  • Paget Disease, Extramammary / surgery
  • Paget Disease, Extramammary / therapy*
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Treatment Outcome
  • Vulvar Neoplasms / pathology*
  • Vulvar Neoplasms / surgery
  • Vulvar Neoplasms / therapy*