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Risk stratification in extramammary Paget disease.

J M Cohen¹, S R Granter², A E Werchniak^3,4

¹Harvard Medical School, Boston, MA, USA.

Clinical and Experimental Dermatology

|May 27, 2015

Summary

Extramammary Paget disease (EMPD) risk stratification is aided by understanding prognostic factors like invasion depth and extracutaneous spread. Emerging data on tumor genetics also aids in assessing Extramammary Paget disease (EMPD) prognosis.

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Area of Science:

Oncology
Dermatology

Background:

Extramammary Paget disease (EMPD) is a rare intraepithelial adenocarcinoma affecting apocrine gland-rich areas.
Risk stratification and treatment planning for EMPD present clinical challenges.

Purpose of the Study:

To review prognostic factors for Extramammary Paget disease (EMPD).
To assist physicians in risk stratifying EMPD patients.

Main Methods:

Review of existing literature on Extramammary Paget disease (EMPD) prognostic indicators.
Analysis of data on depth of invasion, extracutaneous involvement, and tumor genetics (Ki-67, cyclin D1, Mucin 5AC, E-cadherin).

Main Results:

Tumor invasion into the reticular dermis or depth > 1 mm indicates poorer prognosis.
Extracutaneous spread (lymph nodes, other tissues) signifies higher risk.
Tumor genetics show emerging importance, while lesion site and patient age have less evidence.

Conclusions:

Depth of invasion and extracutaneous involvement are key prognostic factors in EMPD.
Tumor genetics are increasingly recognized for their role in EMPD risk stratification.
This review provides valuable information for clinical practice and EMPD research.