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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gynecological Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1520528
This article is part of the Research Topic Diagnosis and Treatment of Vulvar Cancer View all 6 articles

The Impact of Radiotherapy on disease control in Vulvar Extramammary Paget's disease : a retrospective study from a single institution

Provisionally accepted
Aeran Seol Aeran Seol 1,2Se Ik Kim Se Ik Kim 1Yong Sang Song Yong Sang Song 1,3*
  • 1 Seoul National University, Seoul, Republic of Korea
  • 2 Korea University Anam Hospital, Seoul, Republic of Korea
  • 3 Department of Obstetrics and gynecology, Myongji Hospital, Seoul, Gyeonggi, Republic of Korea

The final, formatted version of the article will be published soon.

    Vulvar Extramammary Paget's disease (EMPD) is a rare intraepithelial carcinoma affecting apocrine gland-bearing skin, primarily in postmenopausal women. Due to its rarity, optimal treatment strategies, especially the role of radiotherapy (RT), are not well established. This study aimed to evaluate the role of Radiation therapy in vulvar EMPD for preserving the functional and aesthetic vulvar tissue with no inferior survival rate who underwent surgical treatment.We conducted a retrospective cohort study of 32 patients diagnosed with vulvar EMPD at Seoul National University Hospital between 2000 and 2024. Clinicopathologic data, including demographics, clinical presentations, histopathology, treatment modalities, and outcomes, were collected. Patients were divided into two groups: those who received neoadjuvant or adjuvant RT (n=9) and those who did not (n=21). Univariate and multivariate analyses were performed to assess factors related to recurrence and progression-free survival (PFS).The median age at diagnosis was 63.8 years (range: 38.0-87.8), with 84.4% of patients being postmenopausal. Among the 32 patients, 30 (93.8%) underwent surgery, and 9 (28.1%) received adjuvant RT. Recurrence rates were similar between the RT (66.7%) and non-RT (66.7%) groups. The median PFS was longer in the RT group (28.1 months) compared to the non-RT group (23.4 months), though this difference was not statistically significant (p=0.395). Univariate and multivariate analyses identified age ≥ 60 years as a borderline predictor of poorer PFS (p=0.053). No significant associations were found between RT and postoperative complications or recurrence risk.In conclusion, while RT did not show a statistically significant survival benefit, our data and previous studies strongly suggest that RT has potential for disease control and it may be the primary treatment before and after surgery in patients extensive vulvar EMPD.

    Keywords: Extramammary Paget's disease, Radiotherapy, Recurrence, postoperative complication, Neoadjuvant radiation therapy, Adjuvant radiation therapy

    Received: 31 Oct 2024; Accepted: 06 Jan 2025.

    Copyright: © 2025 Seol, Kim and Song. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yong Sang Song, Seoul National University, Seoul, Republic of Korea

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