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The Outcome of Chemotherapy for Metastatic Extramammary Paget’s Disease

The efficacy and survival impact of conventional chemotherapies for metastatic extramammary Paget’s disease (EMPD) have not been fully elucidated. This study examined the long-term outcome of chemotherapy for this indication. We conducted a retrospective review of 21 patients with distant metastatic...

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Autores principales: Hashimoto, Hiroki, Kaku-Ito, Yumiko, Furue, Masutaka, Ito, Takamichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918098/
https://www.ncbi.nlm.nih.gov/pubmed/33673310
http://dx.doi.org/10.3390/jcm10040739
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author Hashimoto, Hiroki
Kaku-Ito, Yumiko
Furue, Masutaka
Ito, Takamichi
author_facet Hashimoto, Hiroki
Kaku-Ito, Yumiko
Furue, Masutaka
Ito, Takamichi
author_sort Hashimoto, Hiroki
collection PubMed
description The efficacy and survival impact of conventional chemotherapies for metastatic extramammary Paget’s disease (EMPD) have not been fully elucidated. This study examined the long-term outcome of chemotherapy for this indication. We conducted a retrospective review of 21 patients with distant metastatic EMPD (14 patients treated with chemotherapy and 7 patients treated without chemotherapy). The response rate of chemotherapy and patient survival were statistically analyzed. Among the 14 patients treated with chemotherapy, 12, 1, and 1 patient received docetaxel, paclitaxel, and low-dose 5-fluorouracil plus cisplatin, respectively, as the first-line treatment. The response rate was 50.0% (7/14), and the disease control rate was 64.3% (9/14). The median progression-free survival (PFS) and overall survival (OS) were 16.8 and 27.9 months, respectively. Multivariate analyses revealed that chemotherapy was a significant factor for prolonged PFS (hazard ratio (HR) 0.22, p = 0.038) but not for OS (HR = 1.71, p = 0.54). Ten patients (71.4%) had severe (grade 3 or 4) hematological adverse events. Although conventional chemotherapy improved PFS, we failed to show a significantly improved OS. Considering the frequent adverse events of conventional chemotherapy, targeted therapy may become a mainstay for the treatment of metastatic EMPD.
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spelling pubmed-79180982021-03-02 The Outcome of Chemotherapy for Metastatic Extramammary Paget’s Disease Hashimoto, Hiroki Kaku-Ito, Yumiko Furue, Masutaka Ito, Takamichi J Clin Med Article The efficacy and survival impact of conventional chemotherapies for metastatic extramammary Paget’s disease (EMPD) have not been fully elucidated. This study examined the long-term outcome of chemotherapy for this indication. We conducted a retrospective review of 21 patients with distant metastatic EMPD (14 patients treated with chemotherapy and 7 patients treated without chemotherapy). The response rate of chemotherapy and patient survival were statistically analyzed. Among the 14 patients treated with chemotherapy, 12, 1, and 1 patient received docetaxel, paclitaxel, and low-dose 5-fluorouracil plus cisplatin, respectively, as the first-line treatment. The response rate was 50.0% (7/14), and the disease control rate was 64.3% (9/14). The median progression-free survival (PFS) and overall survival (OS) were 16.8 and 27.9 months, respectively. Multivariate analyses revealed that chemotherapy was a significant factor for prolonged PFS (hazard ratio (HR) 0.22, p = 0.038) but not for OS (HR = 1.71, p = 0.54). Ten patients (71.4%) had severe (grade 3 or 4) hematological adverse events. Although conventional chemotherapy improved PFS, we failed to show a significantly improved OS. Considering the frequent adverse events of conventional chemotherapy, targeted therapy may become a mainstay for the treatment of metastatic EMPD. MDPI 2021-02-12 /pmc/articles/PMC7918098/ /pubmed/33673310 http://dx.doi.org/10.3390/jcm10040739 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hashimoto, Hiroki
Kaku-Ito, Yumiko
Furue, Masutaka
Ito, Takamichi
The Outcome of Chemotherapy for Metastatic Extramammary Paget’s Disease
title The Outcome of Chemotherapy for Metastatic Extramammary Paget’s Disease
title_full The Outcome of Chemotherapy for Metastatic Extramammary Paget’s Disease
title_fullStr The Outcome of Chemotherapy for Metastatic Extramammary Paget’s Disease
title_full_unstemmed The Outcome of Chemotherapy for Metastatic Extramammary Paget’s Disease
title_short The Outcome of Chemotherapy for Metastatic Extramammary Paget’s Disease
title_sort outcome of chemotherapy for metastatic extramammary paget’s disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918098/
https://www.ncbi.nlm.nih.gov/pubmed/33673310
http://dx.doi.org/10.3390/jcm10040739
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