ORLANDO -- Mohs surgery with cytokeratin-7 (CK-7) immunohistochemistry staining effected complete removal of extramammary Paget disease (EMPD) and resulted in a 5-year, 95% recurrence-free cure rate.
Damavandy's retrospective review of 49 cases may seem small, he said, but it is "far and away the biggest cohort that exists, and the only substantial cohort with immunohistochemistry staining of CK-7." The 5-year follow-up is also a strength of the study.
Immunohistochemistry staining with CK-7 allows highly accurate visualization of individual Paget tumor cells, which express a very high level of the protein.
All were treated with Mohs microsurgery enhanced by CK-7 staining of frozen sections.