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作者回顾分析了M.D.Anderson医院近31年收治的65例乳腺外会阴Paget′s病(EMPD)。65例中,男:女为13∶52,中位年龄66岁(38～91岁),外阴47例,肛周11例,阴囊7例;病灶<4cm8例,≥4cm31例,15例属术后复发。其中,Ⅰ组单纯EMPD43例。Ⅱ组EMPD伴浸润性腺癌22例。治疗:Ⅰ组,单手术38例,术后放疗1例,单放疗2例;Ⅱ组,单手术9例,术前放疗1例,术后放疗5例,单放疗4例。放疗:Ⅰ组单用局部一野,TD56～64Gy/27～28次。Ⅱ组用前后对野,TD40～60Gy,2例加间质镭疗20～30Gy。中位随访198个月结果:Ⅰ组,5年局部复发40%,但经放疗的3例已无瘤生存12、21、60个月,无死于
The authors reviewed and analyzed 65 cases of extramural perineal Paget’s disease (EMPD) in the M.D. Anderson Hospital in the past 31 years. In 65 cases, male: female was 13:52, median age was 66 years (38-91 years old), 47 cases of vulva, 11 cases of perianal, 7 cases of scrotum; lesions <4cm 8 cases, ≥ 4cm 31 cases, 15 cases of surgery After recurrence. Among them, 43 cases of group I were pure EMPD. Group II EMPD with invasive adenocarcinoma in 22 cases. Treatment: Group I, 38 cases of single surgery, 1 case of postoperative radiotherapy, 2 cases of single radiotherapy; II group, 9 cases of single surgery, preoperative radiotherapy in 1 case, postoperative radiotherapy in 5 cases, 4 cases of single radiotherapy. Radiotherapy: Group I used a local field, TD56 ~ 64Gy / 27 ~ 28 times. Group II used before and after the field, TD40 ~ 60Gy, 2 cases of interstitial radium therapy 20 ~ 30Gy. Median follow-up of 198 months Results: Group I, 50% local recurrence 40%, but 3 cases of radiotherapy have no tumor survival 12, 21, 60 months, no deaths