Intraoperative Immunostaining for Cytokeratin-7 During Mohs Micrographic Surgery Demonstrates Low Local Recurrence Rates in Extramammary Paget's Disease

被引:33
作者
Damavandy, Ali A. [1 ]
Terushkin, Vitaly [2 ]
Zitelli, John A. [3 ,4 ,5 ,6 ]
Brodland, David G. [3 ,4 ,5 ,6 ]
Miller, Christopher J. [7 ]
Etzkorn, Jeremy R. [8 ]
Shin, Thuzar M. [8 ]
Cappel, Mark A. [9 ]
Mitkov, Mario [9 ]
Hendi, Ali [10 ,11 ]
机构
[1] Dist Dermatol PLLC, 6711 Whittier Ave,Suite 101, Mclean, VA 22101 USA
[2] Weill Cornell Med Ctr, Volunteer Fac, Dept Dermatol, New York, NY USA
[3] Zitelli & Brodland PC, Pittsburgh, PA USA
[4] Univ Pittsburgh, Dept Dermatol, Med Ctr, Pittsburgh, PA 15260 USA
[5] Univ Pittsburgh, Dept Otolaryngol, Med Ctr, Pittsburgh, PA 15260 USA
[6] Univ Pittsburgh, Med Ctr, Dept Plast Surg, Pittsburgh, PA USA
[7] Hosp Univ Penn, Dept Dermatol, Div Dermatol Surg, Philadelphia, PA 19104 USA
[8] Hosp Univ Penn, Dept Dermatol, Philadelphia, PA 19104 USA
[9] Mayo Clin, Dept Dermatol, Jacksonville, FL 32224 USA
[10] Ali Hendi MD PC, Chevy Chase, MD USA
[11] Georgetown Univ Hosp, Dept Dermatol, Washington, DC 20007 USA
关键词
EXPERIENCE; EXCISION; MAMMARY;
D O I
10.1097/DSS.0000000000001355
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
BACKGROUND Extramammary Paget's disease (EMPD) is a rare intraepithelial malignancy with high recurrence rates following standard surgical treatments, ranging from 22% to 60% in large retrospective reviews. OBJECTIVE To evaluate the local recurrence rate of Mohs micrographic surgery (MMS) supplemented with intraoperative immunohistochemistry for cytokeratin-7 (MMS + CK-7) for primary and recurrent EMPD. MATERIALS AND METHODS Retrospective, multi-center, cross-sectional study of patients treated using MMS + CK-7. Demographic, clinicopathologic, treatment, and follow-up data were obtained by chart review. RESULTS The observed local recurrence rate for MMS + CK-7 is 3.3% (2/61 tumors) with a mean follow-up of 43.5 months (1-120 months). Local recurrence occurred in 2.3% (1/43) of primary tumors and 5.6% (1/18) of recurrent tumors. Kaplan-Meier 5-year tumor-free rates are 94.6% overall, 97.1% for primary tumors, and 80.0% for recurrent tumors. The Kaplan-Meier 5-year tumor-free rates for all EMPD tumors treated with MMS + CK-7 versus a historical cohort of MMS alone are 94.6% versus 72.0% (p = .012). CONCLUSION MMS + CK-7 is an effective treatment for EMPD, demonstrating improved outcomes compared with historical controls.
引用
收藏
页码:354 / 364
页数:11
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