Abstract
This study aims to investigate the safety and efficiency of the holmium laser therapy in extramammary Paget’s disease. The clinical data of 61 patients was collected since 2002 to 2012, confirmed as non-subcutaneous invasive extramammary Paget’s disease by biopsy and underwent surgery. All patients were divided into two groups. Group A included 30 patients who underwent the holmium laser therapy. Group B included 31 patients who underwent the traditional surgical therapy. The clinical data of all patients included preoperative, intraoperative, and postoperative management and follow-up records. Compared with the traditional operation group, the holmium laser group had a shorter operation time and was easier to perform. There were no significant differences between the two groups in cases of intraoperative and postoperative complications, the recurrence-free survival, and the disease-specific survival. But the holmium laser group had a longer recovery time than the traditional operation group in large and deep nidus. Multiple-factor analysis of prognostic parameters of 61 patients confirmed that any of these two methods chosen was not a prognostic parameter for recurrence-free survival. The holmium laser therapy might prove to be a preferable alternative to the traditional operative therapy of extramammary Paget’s disease. However, the holmium laser therapy did not demonstrate to have an obvious advantage over traditional operative therapy in the recurrence-free survival and the disease-specific survival.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Paget J (1874) On disease of the mammary areola preceding cancer of the mammary gland. St Bartholomew Hosp Res (Lond) 10:87–89
Crocker HR (1888–1889) Paget’s disease affecting the scrotum and the penis. Trans Pathol Soc (Lond) 40:187–191
Kanitakis J (2007) Mammary and extramammary Paget’s disease. J Eur Acad Dermatol Venereol 21:581–590
Chanda JJ (1985) Extramammary Paget’s disease: prognosis and relationship to internal malignancy. J Am Acad Dermatol 13:1009–1014
Zollo JD, Zeitouni NC (2000) The Roswell Park Cancer Institute experience with extramammary Paget’s disease. Br J Dermatol 142:59–65
Garzetti GG, Bertani A, Tranquilli AL, Tiriduzzi M, Valensise H, Romanini C (1992) Paget’s disease of the vulva: advantages of demolitive surgery. Eur J Gynaecol Oncol 13(suppl 1):74–77
Petkovic S, Jeremic K, Vidakovic S, Jeremic J, Lazovic G (2006) Paget’s disease of the vulva—a review of our experience. Eur J Gynaecol Oncol 27:611–612
Louis-Sylvestre C, Haddad B, Paniel BJ (2001) Paget’s disease of the vulva: results of different conservative treatments. Eur J Obstet Gynecol Reprod Biol 99:253–255
Maclean AB, Makwana M, Ellis PE, Cunningham F (2004) The management of Paget’s disease of the vulva. J Obstet Gynecol 24:124–128
Preti M, Micheletti B, Ghiringhello B, Privitera S, Condello V, Chieppa P et al (2000) Vulvar Paget’s disease. Clinicopathologic review of the literature. Minerva Ginecol 52:203–211
Bergen S, DiSaia PJ, Liao SY, Berman ML (1989) Conservative management of extramammary Paget’s disease of the vulva. Gynecol Oncol 33:151–156
Tebes S, Cardosi R, Hoffman M (2002) Paget’s disease of the vulva. Am J Obstet Gynecol 187:281–284
Molinie V, Paniel BJ, Lessana-Leibowitch M, Moyal Barracco M, Pelisse M, Escande JP (1993) Paget disease of the vulva. 36 cases. Ann Dermatol Venereol 120:522–527
Black D, Tornos C, Soslow RA, Awtrey CS, Barakat RR, Chi DS (2007) The outcomes of patients with positive margins after excision for intraepithelial Paget’s disease of the vulva. Gynecol Oncol 104:547–550
Fishman DA, Chambers SK, Schwartz PE, Kohorn EI, Chambers JT (1995) Extramammary Paget’s disease of the vulva. Gynecol Oncol 56:266–270
Gunn RA, Gallager HS (1980) Vulvar Paget’s disease: a topographic study. Cancer 46:590–594
Valentine BH, Arena B, Green E (1992) Laser ablation of recurrent Paget’s disease of vulva and perineum. J Gynecol Surg 8:21–24
Weese D, Murphy J, Zimmern PE (1993) Nd:YAG laser treatment of extramammary Paget’s disease of the penis and scrotum. J Urol (Paris) 99:269–271
Ewing TL (1991) Paget’s disease of the vulva treated by combined surgery and laser. Gynecol Oncol 43:137–140
Choi JB, Yoon ES, Yoon DK, Kim DS, Kim JJ, Cho JH (2001) Failure of carbon dioxide laser treatment in three patients with penoscrotal extramammary Paget’s disease. BJU Int 88:297–298
Acknowledgments
The design and conduct of this study were supported by grants from National Matural Science Foundation of China (register numbers: 81271603, 81202030 and 81372761).
Conflict of interest
Song Xishuang certifies that there are no conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (e.g., employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending).
Author information
Authors and Affiliations
Corresponding authors
Additional information
Li Ziyao and Yang Deyong have contributed equally to this work and should be considered co-first authors.
Rights and permissions
About this article
Cite this article
Ziyao, L., Deyong, Y., Xiangyu, C. et al. Clinical research of holmium laser therapy in extramammary Paget’s disease. Lasers Med Sci 29, 1907–1912 (2014). https://doi.org/10.1007/s10103-014-1599-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10103-014-1599-z