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TOPLINE
Women with extramammary Paget disease (EMPD) showed a lower risk for cancer-specific and all-cause mortality compared with men in a study of Surveillance, Epidemiology, and End Results (SEER) data from 2004-2021.
METHODOLOGY
- Researchers conducted a retrospective cohort study of 3472 adult patients with EMPD (66.6% were women) from the SEER database from 2004 through 2021.
- Disease stage was categorized as unstaged, local (no spread), regional (nearby nodes/tissues), or distant (beyond local nodes/tissues), based on SEER summary stage categories.
- Primary outcomes were 5-year cancer-specific survival (CSS) and overall survival (OS).
- Median follow-up was 4.75 years and the median time from diagnosis to treatment was 38 days.
TAKEAWAY
- Women showed improved 5-year CSS (hazard ratio [HR], 0.52; P = .013) and 5-year OS (HR, 0.71; P = .005) compared with men.
- Regional disease (HR, 4.07; P < .001) and distant disease (HR, 14.75; P < .001) were associated with worse 5-year CSS than localized disease; 5-year OS outcomes (HR, 1.82 and 4.93; P < .001) were also poorer for regional and distant disease.
- Patients aged 75 years and older demonstrated significantly worse 5-year CSS (HR, 1.48; P = .035) and OS (HR, 3.84; P < .001) compared with those younger than 65 years. Among men, penoscrotal disease was associated with improved 5-year OS (HR, 0.77; P = .016) compared with non-anogenital skin disease.
- No treatment, radiotherapy and/or systemic therapy alone, and surgery combined with radiotherapy and/or systemic therapy were each associated with significantly worse 5-year CSS and OS compared with surgery alone.
IN PRACTICE
"In this analysis, female sex was associated with improved CSS and OS," the authors wrote. This finding, they added, "should be interpreted in the context of sex-linked EMPD anatomic subtypes, which differ in invasive behavior and recurrence patterns and may not be fully captured in registry data."
SOURCE
The study was led by Gloria Fung, Emory University School of Medicine, Atlanta. It was published online on September 22 in the Journal of the American Academy of Dermatology.
LIMITATIONS
The study was subjected to potential misclassification and selection bias inherent to registry-based analyses. Disease-specific information was also limited in the SEER database.
DISCLOSURES
The authors reported no direct funding for this study. The Biostatistics Shared Resource of Winship Cancer Institute at Emory University, which supported the research in part, was itself funded by the National Institutes of Health/National Cancer Institute. The authors also acknowledged the Crotts Global Initiative for EMPD for its support. The authors reported having no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
