Revolutionary Modified Mohs Surgery Slashes Recurrence of Paget’s Disease!
July 27, 2024
In an exciting breakthrough, a groundbreaking study has revealed that a specialized surgical approach—modified Mohs surgery—significantly enhances the chances of remaining cancer-free for women battling extramammary Paget’s disease (EMPD). This pivotal research, hitting the pages of the American Journal of Obstetrics and Gynecology (AJOG), is set to change the landscape of treatment for this challenging ailment.
While traditional wide local excision (WLE) has been the go-to method, the Mayo Clinic team has shown that their tailored surgical plan offers superior outcomes. Previous studies indicated that margin-controlled techniques, like modified Mohs surgery, have already proven effective in male patients with EMPD. Curious to see if this success translates to female patients, the research team took a closer look.
“This condition is a source of great frustration for both patients and healthcare professionals,” shares a leading gynecologic oncologist. “We witnessed too many recurrences using the standard methods, so we set out to find a better answer.”
EMPD, particularly in women, can be debilitating, as echoed by another expert in the field. “The recurring nature of this disease can leave patients feeling hopeless,” she notes, emphasizing the pressing need for effective treatment options.
Study Insights
Vulvar lesions Illustration depicting vulvar lesions related to genital skin cancer.
Inked margins Precision in Mohs surgery for EMPD: inked margins ensure accuracy.
Excising moat Using a moat technique to ensure clear margins in modified Mohs surgery.
The study compared two groups of patients with EMPD:
- Those who received the traditional WLE treatment.
- Those who benefited from the innovative multidisciplinary approach utilizing Mohs surgery.
Impressive results emerged: while only 65.9% of patients treated with WLE enjoyed a three-year recurrence-free survival, a remarkable 93.3% of those undergoing Mohs surgery achieved the same milestone.
This advanced protocol involved careful pre-surgical biopsies and a meticulous Mohs surgery process, which ensured that cancerous margins were completely cleared. What’s more, the team found that while patients undergoing Mohs surgery required more complex reconstructive procedures, the benefits far outweighed the challenges.
The Intricacies of Mohs Surgery
Though modified Mohs surgery has been shown to dramatically improve short-term outcomes, it is no walk in the park. The process involves meticulously excising tiny strips of skin and conducting microscopic examinations until a cancer-free section is located. This attention to detail is crucial, as EMPD can hide beneath the surface, making it vital to ensure clean margins, especially in sensitive areas.
“It’s a delicate balance,” explains a key figure in the research. “We must be aggressive in treatment but careful not to damage essential structures.” The findings suggest that while Mohs surgery excels for certain lesions, it requires further refinement to address those affecting sensitive areas effectively.
How Mayo Clinic is Leading the Charge
At the forefront of EMPD treatment, Mayo Clinic provides unparalleled expertise. With a dedicated team of gynecologic oncologists, dermatologists, and plastic surgeons, they offer comprehensive care for women facing this rare condition.
“We are committed to delivering the best possible outcomes,” states a Mayo Clinic expert. Their collaborative approach ensures that all aspects of a patient’s health, including functional and sexual needs, are met. For those who have faced WLE at other facilities and are left with residual disease, Mayo Clinic is ready to step in and provide specialized care.
About Extramammary Paget’s Disease
EMPD may be rare, but its implications can be severe. Even experienced professionals may struggle with the complexities of this condition, leading to confusion among patients about its seriousness. “At our facility, we recognize EMPD as a legitimate cancer with potentially life-threatening consequences,” one expert clarifies.
Symptoms can range widely, often presenting as persistent itching or other discomforts. Unfortunately, misdiagnosis is common, with many patients initially receiving ineffective treatments that delay accurate diagnosis. Experts advocate for immediate biopsies when conventional treatments fail.
A thorough evaluation, including comprehensive cancer screenings, is crucial for those diagnosed with EMPD.
Want to Learn More?
For more insights into Mohs surgery and its role in treating female genital Paget’s disease, check out the latest research in the American Journal of Obstetrics and Gynecology.
