title: Paget's disease of the vulva: a clinicopathologic institutional review.
abstract: BACKGROUND
  The aim of this study was to assess the clinicopathologic characteristics of patients with Paget's disease of the vulva who were treated by our gynecologic oncology service between 1985 and 2010.
  
  
  METHODS
  Vulvar Paget's disease patient demographics, pathologic diagnosis, treatment and follow-up data were reviewed over a 25-year period.
  
  
  RESULTS
  The vulvar Paget's disease patients were primarily (62.5%) treated with a partial simple vulvectomy. Three patients had a history of malignancy, although none of them was intercurrent. Eleven patients had microscopically positive margins, 5 of whom developed progressive disease. Conversely, 5 patients had negative margins, of whom 4 had recurrent disease. There was a significant relationship between the presence of invasive disease and patient progression-free interval (PFI) (p = 0.007), but margin status and lesion size did not correlate with PFI (p > 0.05). Median patient PFI and follow-up was 30 and 53 months, respectively.
  
  
  CONCLUSIONS
  We found a significant relationship between the presence of invasive disease and patient PFI in vulvar Paget's disease although the presence of microscopic positive margins and lesion size were not prognostic indicators. In patients with high risk factors, prolonged surveillance should be considered an essential component of optimal patient management.
authors.affiliation: Gynecologic Oncology Associates, Hoag Cancer Center, 351 Hospital Road, Suite 507, Newport Beach, CA 92663, USA.
authors.forename: Alberto A
authors.initials: AA
authors.lastname: Mendivil
authors.forename: Lisa
authors.initials: L
authors.lastname: Abaid
authors.forename: Howard D
authors.initials: HD
authors.lastname: Epstein
authors.forename: Mark A
authors.initials: MA
authors.lastname: Rettenmaier
authors.forename: John V
authors.initials: JV
authors.lastname: Brown
authors.forename: John P
authors.initials: JP
authors.lastname: Micha
authors.forename: Marie A
authors.initials: MA
authors.lastname: Wabe
authors.forename: Bram H
authors.initials: BH
authors.lastname: Goldstein
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy; D010145:Paget Disease, Extramammary / Q000473:pathology* / Q000628:therapy; D014844:Vulva / Q000473:pathology*; D014846:Vulvar Neoplasms / Q000473:pathology* / Q000628:therapy