Evidence map›Paper›PMID 33625139›Full record

ArticleDermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]2021

Treatment of Extramammary Paget Disease and the Role of Reflectance Confocal Microscopy: A Prospective Study.

Cristian Navarrete-Dechent, Saud Aleissa, Miguel Cordova, Brian P Hibler, Andres M Erlendsson, Max Polansky, Frank Cordova, Erica H Lee, Klaus J Busam, Travis Hollmann and 5 more

Abstract read
In one paragraph

Article in Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Review
  2. Anal adenocarcinoma with perianal Paget's disease: A case report.World journal of gastrointestinal surgery · 2025
    Article
  3. Article
  4. Article
  5. Review
  6. Article
  7. Article
  8. Article
  9. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Cristian Navarrete-DechentDepartment of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.
Saud AleissaDermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Miguel CordovaDermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Brian P HiblerDermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Andres M ErlendssonDermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Max PolanskyDermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Frank CordovaDepartment of Biology, Stony Brook University, Stony Brook, New York.
Erica H LeeDermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Klaus J BusamDepartment of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.
Travis HollmannDepartment of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.
Cecilia LezcanoDepartment of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.
Andrea MoyDepartment of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.
Melissa PulitzerDepartment of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.
Mario M LeitaoGynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Anthony M RossiDermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
NCI NIH HHS L30 CA231456NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

backgroundExtramammary Paget disease (EMPD) poses treatment challenges. Invasive and noninvasive treatment modalities exist with variable success reported. Reflectance confocal microscopy (RCM) is emerging as an adjuvant diagnostic tool.

objectiveTo evaluate the treatment of EMPD patients and the role of RCM.

methodsProspective study. Demographic and tumor characteristics were recorded. Handheld-RCM was performed and correlated with histology. Treatment, clearance, pathology, and follow-up were all recorded.

resultsThirty-six EMPD lesions in 33 patients were included. Mean age was 71.7 years, and 23 were men. Mean number of surgical stages needed to clear margins was 1.9 (SD, 0.9; 1.0-3.0 stages), and mean margin needed to clear was 1.8 cm. Reflectance confocal microscopy correlated well with scouting punch biopsies (kappa, 0.93; p < .001). Disruption of the dermoepidermal junction was associated with invasive EMPD versus in situ (83.3% vs 25.9%) on histology (p = .01). LIMITATIONS: Relatively small sample size.

conclusionExtramammary Paget disease is challenging, and lesion demarcation is of the utmost importance. Using a staged surgical excision approach, the mean margins needed were 1.8 cm, less than previously reported. Nonsurgical modalities, including radiation therapy, imiquimod, or photodynamic therapy can be considered if surgery is not pursued. Reflectance confocal microscopy is a valuable noninvasive imaging modality for the management of EMPD.

Indexed as

Margins of ExcisionAgedAged, 80 and overBiopsyDermatologic Surgical ProceduresFemaleHumansMaleMicroscopy, ConfocalMiddle AgedPaget Disease, ExtramammaryProspective StudiesSkin Neoplasms

Identifiers

PMID33625139
PMCPMC10599152

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.