title: Comparison of Mohs micrographic surgery and wide excision for extramammary Paget's Disease: Korean experience.
abstract: BACKGROUND
  Extramammary Paget's disease (EMPD) is an uncommon tumor that usually occurs on the genitalia. It almost always extends beyond clinically apparent margins and has a high rate of recurrence.
  
  
  OBJECTIVE
  To establish treatment guidelines for EMPD in Asian patients.
  
  
  METHODS
  A retrospective review was done on pertinent demographic data, tumor data, treatment characteristics, and follow-up data of 35 patients between 1996 and 2006. Review of literature for treatment modalities and recurrence rates of EMPD was also performed.
  
  
  RESULTS
  Thirty-four of the 35 patients (30 men and 5 women) had lesions in the genital area and one patient in the axilla. Mean follow-up duration was 62.7 months (8-156 months) and two of 11 (18.2%) recurred after Mohs micrographic surgery (MMS), compared with eight recurrences of 22 (36.4%) after standard wide excision. Two patients treated with nonsurgical modalities did not achieve complete remission. Estimated 5-year tumor-free rate using Kaplan-Meier graph was 69.7% in all patients, with a rate of 81.8% for MMS and 63.6% for wide excision.
  
  
  CONCLUSIONS
  MMS is more effective, with lower recurrence rate than wide excision, and should be regarded as the first-line treatment for nonmetastatic EMPD.
authors.affiliation: Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seodaemoon-gu, Seoul, Korea.
authors.forename: Kyu-Yeop
authors.initials: KY
authors.lastname: Lee
authors.forename: Mi Ryung
authors.initials: MR
authors.lastname: Roh
authors.forename: Woo Gil
authors.initials: WG
authors.lastname: Chung
authors.forename: Kee Yang
authors.initials: KY
authors.lastname: Chung
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D010145:Paget Disease, Extramammary / Q000601:surgery*; D012878:Skin Neoplasms / Q000601:surgery*