Analysis of Treatment Methods and Prognosis for Patients with Extramammary Paget’s Disease for 20 Years at a Single Tertiary Medical Institution: Carcinoembryonic Antigen as a Risk Factor for Metastasis / 대한피부과학회지

ABSTRACT

Background@#Extramammary Paget’s disease (EMPD) is a rare cutaneous malignancy of anogenital lesions. @*Objective@#To investigate the long-term prognosis of patients with EMPD and the results of various treatment methods for 20 years. @*Methods@#We retrospectively reviewed the medical records of 80 patients with biopsy-proven EMPD at Chonnam National University Hospital during the last 20 years from 2000 to 2019. @*Results@#The most common treatment option was excision in male patients (75.0%). However, for female patients, nonsurgical treatments, such as topical imiquimod (29.1%) or radiation therapy (20.8%), were mostly applied. In the long-term follow-up, 10 patients (12.5%) were diagnosed with systemic metastasis. The most common metastatic site was the lymph nodes, followed by the bone. Among patients with metastasis, 66.7% showed elevated serum carcinoembryonic antigen (CEA) levels, whereas none of the non-metastatic patients showed elevated CEA levels. Negative surgical margins were not associated with systemic metastasis but were associated with local recurrence. @*Conclusion@#Systemic metastasis of EMPD is significantly associated with serum CEA levels. Therefore, more rigorous follow-up, including imaging studies, is required for patients with a poor prognosis.