Cytoreductive combination chemotherapy for regionally advanced unresectable extramammary Paget carcinoma

Abstract

Extramammary Paget carcinoma (EPC) is considered to originate from the eccrine and apocrine glands of the adnexal skin of the axilla, vulva or penis, scrotum, or perineum. If immunohistochemical techniques with the use of cytoskeletal markers are applied in addition to histologic examination, EPC lesions are found to be multifocal adenocarcinoma of the adnexal sweat glands. So far, therapeutic approaches have included primary surgery, followed optionally by radiation therapy. It is possible to achieve a cure only when manifestations are detected early and confined regionally. The role of palliative chemotherapy has not yet been assessed in this disease, particularly because of the lack of compliance and follow‐up in patients with EPC. Cancer 1992; 70:704–708.

Role of Radiotherapy as Curative Treatment of Extramammary Paget’s Disease

“…Various chemotherapeutic agents have been used, but no standardized regimen currently exists. Some investigators have presented case reports documenting the effective treatment of primary, recurrent, or metastatic tumors of EMPD with cisplatin, carboplatin, 5-fluorouracil, vincristine, bleomycin, mitomycin C, etoposide, or docetaxel, either alone or combined (3,4,(31)(32)(33). However, almost all the follow-up periods were #2 years, and the effects of chemotherapy on the prognosis of EMPD patients are still unknown.…”

Low-dose mitomycin C, etoposide, and cisplatin for invasive vulvar Paget's disease

“…Balducci et al (13) reported a CR in a patient with extramammary Paget's disease with continuous 5‐FU administration combined with MMC. Voigt et al (3) reported a CR in a similar patient using carboplatin, 5‐FU, and calcium folinate. These regimens used standard chemotherapy doses approved for other gynecological malignancies in young patients.…”

Management of Penoscrotal Extramammary Paget Disease: Case Series and Review of the Literature

“…Invasive genitourinary tract cancers (prostate, bladder, kidney) [22][23][24][25][26][27][28] or gastrointestinal sites (colon, rectum, liver) 29,30 can be associated, synchronously or metachronously, with penoscrotal empd, but the frequency of this association is not consistently reported. In a recent M.D.…”