Extramammary Paget's disease of the penis and anogenital area: SEER analysis.

Abstract

220 Background: Extramammary Paget's disease (EMPD) is a rare cancer with poorly described outcomes comprising primarily single-institution small case series. We used the Surveillance, Epidemiology, and End Results (SEER) registries to further define survival and predictors of survival in EMPD. Methods: 17 SEER registries were queried for male patients diagnosed with EMPD from 1973 to 2007. Patients were categorized by: penis and anogenital structures (anorectum, scrotum, and skin). Descriptive analyses were conducted to characterize each group including age, year of diagnosis, race, tumor stage, and treatment. Kaplan-Meier and multivariate Cox regression analyses were performed. Results: The cohort consisted of 328 patients. Overall survival based on primary sites of EMPD were: anorectum (24.3%), scrotum (62.4%), penis (62.5%), skin (50.8%). Controlling for patient and disease characteristics, significant factors negatively impacting survival were primary site in the anorectal region compared to scrotum, penis and skin (p<0.001, p=0.008, p=0.005 respectively), presence of distant disease versus localized disease (p=0.01) and radiation only (RT) treatment versus surgery alone (p=0.016). Survival benefit was not increased in patients who underwent combined RT and surgery treatment, as compared to those who were treated with surgery alone (p=0.61). Conclusions: Predictors of lower survival in men with EMPD in this cohort include anorectal location, distant disease and RT-only treatment. RT in addition to surgery does not appear to confer increased survival. [Table: see text] No significant financial relationships to disclose.