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Interdisciplinary Management of Extramammary Paget's Disease Using Mohs Micrographic Surgery With Frozen Section Cytokeratin-7 Immunostains

Interdisciplinary Management of Extramammary Paget's Disease Using Mohs Micrographic Surgery With Frozen Section Cytokeratin-7 Immunostains

Authors :
Julie M. Bittar
Peter G. Bittar
Shannon T. Nugent
Leela K. Raj
Donald E. Neal
Mohammed Dany
Marilyn T. Wan
John Sharkey
Jeremy R. Etzkorn
Joseph F. Sobanko
Thuzar M. Shin
Stephen Kovach
Robert C. Kovell
Nawar Latif
Christopher J. Miller
Source :
Urology. 166
Publication Year :
2022

Abstract

To describe local recurrence rates and patient-reported outcomes when Mohs micrographic surgery with cytokeratin-7 immunostains (MMS-CK7) is included in the interdisciplinary management of extramammary Paget's disease (EMPD) METHODS: A retrospective study was conducted of EMPD treated with MMS-CK7 as part of an interdisciplinary team at an academic medical center between 2009 and 2016. Local recurrence rates and patient-reported outcomes were determined by record review and patient surveys.Twenty tumors in 19 patients were treated using MMS-CK7. After MMS-CK7 defined clear microscopic margins, 75% (15/20) of tumors underwent excision or reconstruction by a surgical colleague. Internal malignancy screening was performed by multiple specialties in 17 patients, with 1 associated malignancy of prostate cancer detected. No local recurrence was detected with a mean follow-up of 75.2 months. Most patients were satisfied with appearance (18/19, 95%) and function (16/19, 84%) after surgery.Interdisciplinary teams that include MMS-CK7 can treat EMPD with low local recurrence rates, high patient satisfaction, and thorough internal malignancy screening.

Details

ISSN :
15279995
Volume :
166
Database :
OpenAIRE
Journal :
Urology
Accession number :
edsair.doi.dedup.....d63ab2158548b14102f3cef38c22a6b5