title: Penile and scrotal Paget's disease: 130 Chinese patients with long-term follow-up.
abstract: OBJECTIVE
  To report a retrospective series of 130 Chinese patients with penoscrotal extramammary Paget's diseases (EMPD), with a long-term follow-up, and thus improve the diagnosis and therapy of this disease.
  
  
  METHODS
  The history, clinical presentation, pathology, treatment, and prognosis of 130 patients were analysed. All cases were confirmed by skin biopsy, and then the patients had local wide resection to remove the involved skin and subcutaneous tissue. The large defective wound was reconstructed using a split-thickness skin graft or local flap.
  
  
  RESULTS
  Forty-five patients were evaluated by frozen-section biopsy of the margins during surgery, five of whom had positive margins and then had an extended resection immediately. Most of these patients had local skin or adjacent scrotal flaps to cover their skin defects. Of the 130 patients, 81 had a mean (range) follow-up of 3.2 (0.5-10) years after surgery. Five of nine patients with positive margins and three (4%) of 72 with negative margins had tumour recurrence. Five patients died from metastatic disease.
  
  
  CONCLUSIONS
  Penoscrotal EMPD needs be differentiated from other chronic dermatitis. A 3 cm surgical margin should be sufficient and frozen-section pathological examinations are necessary for some complicated conditions. Skin grafts or local flaps are good for large skin defects.
authors.affiliation: Department of Urology, Shanghai 9th People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Wang
authors.forename: Mujun
authors.initials: M
authors.lastname: Lu
authors.forename: Guo-Qin
authors.initials: GQ
authors.lastname: Dong
authors.forename: Yue-Qing
authors.initials: YQ
authors.lastname: Jiang
authors.forename: Mei-Sui
authors.initials: MS
authors.lastname: Lin
authors.forename: Zhi-Kang
authors.initials: ZK
authors.lastname: Cai
authors.forename: Jun
authors.initials: J
authors.lastname: Ying
authors.forename: Xiaomin
authors.initials: X
authors.lastname: Ren
authors.forename: Benchun
authors.initials: B
authors.lastname: Liu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods; D002681:China; D005500:Follow-Up Studies; D005832:Genital Diseases, Male / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010145:Paget Disease, Extramammary / Q000473:pathology / Q000601:surgery*; D010409:Penile Diseases / Q000473:pathology / Q000601:surgery; D010413:Penis / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D012611:Scrotum / Q000473:pathology / Q000601:surgery*; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods*