PD31-09 SURGICAL STRATEGY AND OUTCOMES OF PENOSCROTAL PAGET's DISEASE: A LARGE RETROSPECTIVE COHORT STUDY IN A CHINESE TERTIARY CENTER

Field: Medicine (Health Sciences)

You have accessJournal of UrologyReconstruction: External Genitalia and Urotrauma (including transgender surgery and traumatic fistula) I (PD31)1 May 2024PD31-09 SURGICAL STRATEGY AND OUTCOMES OF PENOSCROTAL PAGET's DISEASE: A LARGE RETROSPECTIVE COHORT STUDY IN A CHINESE TERTIARY CENTER Xiang Wan, Bin Xu, and Haijun Yao Xiang WanXiang Wan , Bin XuBin Xu , and Haijun YaoHaijun Yao View All Author Informationhttps://doi.org/10.1097/01.JU.0001009432.48553.4f.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Penoscrotal Paget's disease is a rare malignant skin tumor, and consensus on assessment, reconstruction, treatment strategies, and prognosis remains elusive. We aimed to elucidate the clinical features, surgical outcomes, and prognosis, proposing a tailored Perineal Reconstruction (PR) strategy. METHODS: We conducted a retrospective cohort study using pathologically confirmed penoscrotal Paget's disease cases from a large tertiary hospital pathology registry between May 2004 and February 2021. Clinical features, surgical treatment patterns, sexual function, and prognosis were analyzed. The PR strategy was proposed to assess the lesion and guide surgery. Kaplan-Meier analysis, univariate and multivariate Cox regression were performed to identify prognostic factors. RESULTS: In total, 233 penoscrotal Paget's disease patients were included. The median age was 71 years, with a median diagnostic delay of 28 months. Most patients presented with large defects, thin tumors, and erythematous plaques. Of the patients, 233 underwent frozen biopsy-guided wide local excision, and 17 received lymph node dissection. Additionally, 16 patients required re-excision with positive margins. PR strategy-based reconstruction was applied on all postsurgical defects. The median follow-up was 67 months. No significant difference in preoperative and postoperative overall satisfaction was found. Kaplan-Meier analysis indicated worse disease free-survival (DFS) in the high-PR score (≥ 4) group compared to the low-PR score (≤ 3) group. Age, tumor thickness, and lymph node invasion emerged as independent predictors of OS. CONCLUSIONS: Early evaluation and intervention are crucial to prevent vertical and lymph node invasion. Wide local excision provides low recurrence, high overall survival rates, and acceptable sexual function. The PR strategy serves as a promising approach to assess lesions, guide reconstruction, and predict prognosis, potentially improving treatment and management of this rare malignancy. Download PPTDownload PPT Source of Funding: The manuscript was supported by the Project of Biobank of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (YBKB202119); Medical Research Foundation of Shanghai Science and Technology Commission (20Y11904300); Clinical Research Foundation of Shanghai Municipal Health Commission (202040437); National Natural Science Foundation of China (82200745) © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e633 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Xiang Wan More articles by this author Bin Xu More articles by this author Haijun Yao More articles by this author Expand All Advertisement PDF downloadLoading ...