Biomedical subjects

H E Geisler

Publications and source records attributed to H E Geisler.

At least 37 records · Page 2Linked to original sources

PubMed1998

Heat shock protein 27: an independent prognostic indicator of survival in patients with epithelial ovarian carcinoma.

OBJECTIVE: Heat shock protein 27 (HSP27) is produced in response to pathophysiologic stress in animal cells. The purpose of this study was to determine prospectively whether HSP27 was associated with known prognostic factors as well as survival in patients with epithelial ovarian carcinoma. METHODS: Ninety-nine patients with epithelial ovarian carcinoma were studied. Slides were prepared from fresh tissue. Patient records were examined for FIGO stage, grade, histology, level of cytoreduction, and survival. RESULTS: Immunohistochemical staining for HSP27 was not related to histologic grade, level of cytoreduction or histologic subtype. A statistically significant difference in HSP27 staining was found in relation to FIGO stage (P = 0.013). HSP27 staining was found to be an independent predictor of 2-year survival in these patients (P = 0.041). CONCLUSION: The level of HSP27 significantly decreases as the FIGO stage increases and is an independent prognostic indicator of survival in patients with epithelial ovarian carcinoma.

Adult↗

PubMed1998

Lack of bcl-2 persistence: an independent prognostic indicator of poor prognosis in endometrial carcinoma.

OBJECTIVE: bcl-2 is a protein which prohibits programmed cell death. The purpose of this study was to determine whether bcl-2 staining was related to traditional prognostic factors and/or recurrence in patients with endometrial carcinoma. METHODS: One hundred twenty consecutively surgically treated patients with endometrial carcinoma had their tumors studied immunohistochemically for bcl-2 staining. RESULTS: The mean follow-up of the patients was 53 months with a median of 56 months (range 30 to 68 months). bcl-2 staining was positive in 44.0% of patients with endometrioid carcinomas and in 23. 1% of patients with nonendometrioid carcinomas (P < 0.001). Increasing depth of invasion (P = 0.014), grade (P = 0.011), and FIGO stage (P = 0.018) were each correlated with decreasing bcl-2 staining. bcl-2 staining was positive in 44.1% of patients whose tumors showed no lymphovascular space invasion and in 11.1% of patients with lymphovascular space invasion (P < 0.001). Only 1 of 26 patients with recurrent disease had persistence of bcl-2 staining. Multivariate analysis revealed FIGO stage (P = 0.0051), histologic grade (P = 0.050), and lack of staining for bcl-2 (P = 0.012) to be independent predictors of recurrence. CONCLUSION: bcl-2 persistence is more common in endometrioid than in nonendometrioid adenocarcinomas of the endometrium. It appears to be inversely correlated with the universally recognized prognostic factors of depth of invasion, histologic grade, and FIGO stage. Lack of bcl-2 persistence was an independent predictor of recurrence of disease. This group of patients continues to be followed to determine the role of bcl-2 persistence or lack of persistence as a predictor of 5-year survival of patients with endometrial carcinoma.

Endometrial Neoplasms↗

PubMed1998

Papillary serous carcinoma of the cervix: ultrasonographic findings.

BACKGROUND: Papillary serous carcinoma of the uterine cervix is a rare malignancy only recently described. Optimal treatment is unknown. CASE REPORT: A 65 year old white female, approximately 15 years postmenopausal, presented with a recent history of postmenopausal bleeding. Cervical cytology was negative for any abnormalities. Ultrasonography of the pelvis revealed a thickened anterior endometrium with fluid present along with a papillary mass in the endocervix. Hysteroscopy, dilatation and curettage revealed a low uterine segment mass consistent with a pathologic diagnosis of grade 2 endometrioid adenocarcinoma of the endometrium. A total abdominal hysterectomy, bilateral salpingo-oophorectomy and bilateral pelvic and paraaortic lymphadenectomy revealed a papillary serous carcinoma of the cervix metastatic to pelvic and paraaortic lymph nodes. CONCLUSION: Cervical papillary serous carcinoma can be discovered pre-operatively by ultrasonography. Because of its relatively recent description and relative rarity, optimal treatment is unknown.

Aged↗

PubMed1998

Five-year survival in patients with endometrioid carcinoma of the ovary versus those with serous carcinoma.

BACKGROUND: Ovarian carcinoma is the most deadly of gynecologic malignancies. Controversy exists as to whether different histologic types have a different prognosis. The goal of this study was to determine whether patients with endometrioid carcinoma of the ovary have a different prognosis than patients with serous carcinoma. METHODS: Available records for all patients on the gynecologic oncology service with epithelial ovarian carcinoma from January 1, 1981 through December 31, 1989, were reviewed. Patients with endometrioid ovarian carcinomas were matched with patients with serous carcinoma with regards to age, grade, stage, and level of cytoreduction. RESULTS: Forty-two patients were studied by matching 21 patients with endometrioid carcinoma with 21 patients with serous carcinoma. The 5-year survival of the 21 patients with endometrioid carcinoma was 61.9% while the 5-year survival was 71.4% in the patients with serous carcinoma (P=0.22). Of the patients diagnosed with endometrioid carcinoma, the mean survival was 57 months versus a mean survival of 69 months in patients with serous carcinoma (P=0.30). Estrogen receptor levels were not statistically significantly different between the two groups (P=0.108); however, progesterone receptor levels did prove to be statistically significantly different (P<0.001). CONCLUSIONS: When patients with endometrioid and serous tumours of the ovary are matched for age, grade, stage and level of cytoreduction, there is no difference in either 5-year survival or length of survival.

Carcinoma, Endometrioid↗

PubMed1998

The effect of fixation on the size, shape and summed optical density of endometrial cancer nuclei.

OBJECTIVE: Nuclear morphometric features have been shown to be of prognostic importance in several malignancies including recently, endometrial cancer. The authors attempted to see whether the type of fixation affected nuclear size (NUSZ), shape (NUSH), and summed optical density (NUSD). METHODS: Fifty specimens, half air dried and half alcohol fixed, were obtained from 25 consecutive patients with endometrial cancer. Results were compared with the paired samples t-test. Differences among the nuclear morphometric features and histologic grade, stage, and depth of myometrial invasion were studied by one-way analysis of variance. Logistic regression was used to determine if any were independent prognostic features. Image analysis was used to determine NUSZ, NUSH, and NUSD. RESULTS: Mean NUSZ was shown to be significantly larger in air dried specimens (89.13 microm2) as compared to alcohol fixed specimens (80.34 microm2) P=0.047. Mean NUSH was significantly closer to round in air dried specimens (15.21) as compared to alcohol fixed specimens (15.65) P=0.025. There was no significant difference in mean NUSD between air dried (128.61) and alcohol fixed specimens (126.22) P=0.76. Stage, as well as air dried NUSZ, NUSH, and NUSD were all independent predictors of recurrence. In this study none of the nuclear parameters from the alcohol fixed tissues were predictive of recurrence. CONCLUSION: The type of fixation significantly affects the nuclear morphometric parameters of size and shape. While NUSZ, NUSH, and NUSD from air dried specimens were predictive of recurrence, the same parameters from alcohol fixed specimens were not. A larger prospective trial is currently underway to validate these findings.

Analysis of Variance↗

PubMed1998

Clear cell carcinoma of the ovary: poor prognosis compared to serous carcinoma.

BACKGROUND: A review of literature comparing the survival of patients with clear cell carcinoma of the ovary to patients with serous carcinoma reveals divided opinions. No studies of statistical significance have demonstrated worse survival in a cohort of patients with clear cell carcinoma matched stage for stage with patients with serous carcinoma of the ovary. The purpose of this study was to compare survival in a cohort of clear cell carcinoma patients to a cohort of serous carcinoma patients matched for stage, age, treatment, and cytoreduction. METHODS: All cases of clear cell carcinoma and serous carcinoma of the ovary operated on by the gynecology oncology service from January 1, 1981 to December 31, 1989 were evaluated for patient age, length of survival and level of primary cytoreduction, as well as FIGO stage and histology. RESULTS: Twenty-two patients with clear cell carcinoma found in the years noted were compared to a cohort of 22 patients with serous carcinoma matched for stage (I, 18.2%; II, 9.1%; III, 63.6%; IV, 9.1%), age (clear cell carcinoma 58 years, serous carcinoma 60 years (p = 0.330)), and level of primary cytoreduction (optimal in 63.6% of both clear cell carcinoma and serous carcinoma cohorts and non-optimal in 36.4% of both groups). Survival in the clear cell carcinoma cohort (16 months) was worse than in the serous carcinoma cohort (36 months) (p = 0.045). CONCLUSION: Patients with clear cell carcinoma have a significantly worse prognosis than patients with serous carcinoma when matched for age, stage, and level of primary cytoreduction.

Adenocarcinoma, Clear Cell↗

PubMed1997

Quantification of p53 in epithelial ovarian cancer.

OBJECTIVE: The perceived function of wild-type p53 is suppression of cell proliferation. An alteration in the p53 tumor suppressor gene is a common defect in human malignancies. The purpose of this study was to prospectively determine whether p53 expression, as quantified by image analysis, was related to traditional prognostic indicators as well as survival in patients epithelial ovarian cancer. METHODS: Eighty-three consecutive patients with epithelial ovarian cancer had their p53 expression studied by immunohistochemical staining and quantified by image analysis. Unless otherwise noted, p53 expression was reported as the percentage positive nuclear area staining. RESULTS: The mean follow-up was 37 months (median, 30 months; range 24-55 months). In patients with serous carcinomas of the ovary, the mean p53 expression was 29.4%, whereas in patients with other histologies, the mean was 10.5% (P < 0.001). The tumors of patients with stage III or IV tumors stained significantly higher (mean 28. 7%) than the tumors of patients with stage I or II disease (mean 8. 36%) (P < 0.001). The tumors of patients with disease which could be optimally cytoreduced stained significantly lower (mean 23.0%) than the tumors of patients whose disease was unable to be optimally cytoreduced (mean 28.6%) (P = 0.041). Utilizing survival as the endpoint for multivariate analysis, FIGO stage (P = 0.006), p53 expression (P = 0.046), and the level of cytoreduction (P < 0.001) were independent prognostic indicators. CONCLUSION: Image analysis allows quantitative measurements of p53 staining. p53 staining is significantly higher in advanced-stage, high-grade tumors which are unable to be cytoreduced than in early-stage, low-grade tumors which can be optimally cytoreduced. p53 expression is an independent prognostic indicator of survival in patients with epithelial ovarian carcinomas.

Adult↗

PubMed1997

Extramammary Paget's disease with diffuse involvement of the lower female genito-urinary system.

Extramammary Paget's disease of the lower female genito-urinary system is an uncommon neoplasm with a high rate of recurrence. A 52-year-old white female with a history of extramammary Paget's disease, originally excised in 1985 by skinning vulvectomy and who had multiple recurrences, including two in a vaginal graft and with extension to the urethra and the uterine cervix, in 1992 underwent an anterior pelvic exenteration for control of the disease process. Standard surgical management for extramammary Paget's disease without invasion or without an underlying adenocarcinoma is simple or skinning vulvectomy. However, because the disease commonly recurs, diffuse involvement may require more extensive surgery including pelvic exenteration in extraordinary cases.

Journal Article↗

PubMed1997

A difference in nuclear morphometry when frozen rather than fresh tissue is studied.

OBJECTIVE: Since the value of nuclear morphometry as a prognostic indicator in gynecologic malignancies is beginning to be explored, the authors attempted to see whether there was a difference in the nuclear morphometric features of size, shape and summed optical density in endometrial cancer when touch preparations were made from fresh versus frozen tissue. METHODS: Fifty specimens were obtained from twenty-five consecutive patients with endometrial cancer. Each patient had an air dried touch preparation made from fresh and frozen tissue. Values were compared using paired samples T-test. Logistic regression was used as a type of multivariate analysis. Nuclear size (NUSZ), shape (NUSH), and summed optical density (NUSD) were calculated by image analysis. RESULTS: Mean NUSZ was shown to be significantly larger in fresh specimens (117.3 microns2) when compared to the frozen specimens (89.3 microns2) p < 0.001. Mean NUSH was significantly closed to round in frozen specimens (15.21) when compared to the fresh specimens (15.55) p = 0.038. Mean NSUD was shown to be significantly larger in frozen specimens (128.6) as compared to fresh specimens (120.2) p = 0.045. Stage, NUSZ was NUSD from fresh tissue were shown to be independent predictors of recurrent disease. CONCLUSION: The type of tissue (fresh versus frozen) from which touch preparations are made is important. Significant differences in NUSZ, NUSH, and NUSD were seen between fresh and frozen specimens. While NUSZ and NUSD from fresh specimens were predictive of recurrence, the same parameters from frozen specimens were not. A larger prospective trial is underway to determine the validity of these preliminary conclusions.

Cell Nucleus↗

PubMed1996

DNA index by image analysis in advanced endometrial carcinoma.

BACKGROUND: Endometrial carcinoma is the most common gynecologic malignancy in developed countries, affecting an estimated 140,000 women. More than 32,000 women will be diagnosed with endometrial cancer this year in the United States, and approximately 6,000 will die from this disease. METHODS: Twenty consecutive patients, surgically treated, with advanced endometrial cancer, were evaluated for their DNA index (DI), time to recurrence, peritoneal cytology, depth of invasion, lymphovascular space invasion, as well as FIGO stage, grade, and histology. DI was determined using image analysis. RESULTS: Ten of the 20 patients had recurrence of their disease within the 3-year observation period of the study. A DI of > or = 1.2 strongly predicted recurrence of disease (P = 0.002). Increasing histologic grade and an increasing DI were related (P = 0.01). CONCLUSION: Independent of other prognostic indicators, including lymphovascular space invasion, depth of invasion, and histologic type, a tumor with a DI of > or = 1.2, had a significantly increased chance of recurring within the 3-year observation period.

Aged↗

PubMed1996

Estrogen and progesterone receptor status as prognostic indicators in patients with optimally cytoreduced stage IIIc serous cystadenocarcinoma of the ovary.

BACKGROUND: Steroid receptor status as a prognostic indicator in gynecologic malignancies has been a focus of study for almost 20 years. Although shown to be of importance in assessing prognosis in some patients with endometrial cancer, their importance in assessing prognosis in patients with serous cystadenocarcinoma of the ovary is not established. METHODS: All cases of stage IIIc serous cystadenocarcinoma of the ovary operated on by the gynecologic oncology service from January 1, 1981, through December 31, 1989, were evaluated for their estrogen and progesterone receptor status, time to recurrence, length of survival, and level of primary cytoreduction as well as FIGO stage, grade, and histology, Fresh tissue was obtained and frozen at the time of surgery for the steroid assays. RESULTS: Ninety-six patients who had optimal primary cytoreductive surgery for their stage IIIc serous cystadenocarcinomas of the ovary and had their estrogen and progesterone receptor status established were found. Patients with an estrogen receptor level of less than or equal to 10 fmol/mg cytosol protein were shown to have a better mean survival (41 months) than patients with estrogen receptor levels greater than 10 fmol/mg cytosol protein (34 months) (P = 0.015). Five-year survival in the former group (38 patients) was 39.5% while 5-year survival in the latter group (58 patients) was 10.3% (P = 0.001). The was no correlation between progesterone status and survival (P > 0.05) in that same cohort of patients. CONCLUSIONS: In patients with optimally cytoreduced stage IIIc serous cystadenocarcinoma of the ovary, an estrogen receptor level of less than or equal to 10 fmol/mg cytosol protein may be indicative of a better prognosis. Progesterone receptor status does not appear to affect survival.

Adult↗

PubMed1996

p53 as a prognostic indicator in endometrial cancer.

BACKGROUND: One of the most common genetic alterations to occur in human cancers is an alteration of the p53 tumor suppressor gene. Although endometrial cancer is the most common gynecologic malignancy in the United States, any connection between it and p53 is just beginning to be explored. METHODS: Forty-six consecutively surgically treated patients with endometrial cancer had their p53 expression studied by immunoperoxidase staining and quantified by image analysis. RESULTS: Thirty-five patients had endometrioid adenocarcinomas, 3 had adenosquamous carcinomas, 3 had papillary serous carcinomas, 3 had clear cell carcinomas, and 2 had undifferentiated carcinomas. p53 expression ranged from 0.0 to 55.8% with a mean of 10.7% for the cohort. For the patients with endometrioid carcinomas, the mean p53 expression was 3.9%, while for those with more aggressive histologies it was 32.4% (P < 0.001). Sixteen of the 35 endometrioid tumors (45.7%) stained positive for p53, while 11 of the remaining 12 (91.2%) tumors with more aggressive histologies stained positive (P < 0.01). Increasing histologic grade correlated with an increasing p53 expression (P = 0.006). The percentage of patient tumors expressing p53 was found to be higher in FIGO stage II, III, and IV than in FIGO stage I cancer (P = 0.01). However, the mean p53 expression was not different between early (stage 1) and advanced (stage 11, III, and IV) cancers (P = 0.55). Utilizing recurrence as the endpoint for multivariate analysis, FIGO stage and p53 expression were the only independent prognostic indicators found. CONCLUSION: p53 expression is more common in more aggressive histologic subtypes than in endometrioid adenocarcinomas. It is an independent prognostic indicator of disease recurrence.

Adult↗

PubMed1996

Proliferation index determined by MIB-1 and recurrence in endometrial cancer.

BACKGROUND: Endometrial carcinoma is the most common gynecologic malignancy in developed countries. Stage, grade, DNA index, histologic type, depth of invasion, steroid receptor status, and the presence of positive peritoneal cytology have all been linked to survival. The monoclonal antibody MIB-1 reacts with the same antigen as Ki-67 giving an estimate of proliferation index. The authors investigated whether MIB-1 staining, using image analysis, could be used as a prognostic indicator of recurrence in endometrial carcinoma. METHODS: The tumors from 39 consecutive patients receiving primary surgical therapy for endometrial cancer were evaluated with the MIB-1 monoclonal antibody. Proliferation index was quantified by image analysis. The patients were followed for a median of 34 months and their charts were reviewed to determine recurrence, histologic type, grade, stage, depth of invasion, and status of peritoneal cytology. RESULTS: Eleven of the 39 patients had recurrence of their disease within the 3-year observation period of this study. Overall, 22 patients had stage I disease, 3 patients had stage II disease, 12 patients had stage III disease, and 2 patients had stage IV disease. MIB-1 staining was not significantly elevated in advanced (stage III and IV) as opposed to early (stage I and II) cancers (P = 0.558). Elevated MIB-1 staining was associated with an increased incidence of recurrence within 24 months of diagnosis (P = 0.002). Patients whose tumors had MIB-1 staining of greater than or equal to 39.0% had an increased chance of recurring over patients whose tumors stained less than 39.0% (P = 0.003). CONCLUSION: In this series of 39 patients with endometrial cancers, MIB-1 monoclonal antibody staining was shown to be a prognostic indicator of recurrence.

Analysis of Variance↗

PubMed1996

Markov texture parameters as prognostic indicators in endometrial cancer.

BACKGROUND: Texture is a descriptive property of a surface distinct from color and shape. Image analysis allows gray-scale images to have their optical texture measured and analyzed. The authors, utilizing image analysis, prospectively studied Markov texture parameters to determine their relevance as prognostic indicators of disease recurrence in endometrial cancer. METHODS: Seventy-four consecutive patients, surgically treated, with endometrial cancer, were evaluated for their DNA index (DI), time to recurrence, peritoneal cytology, depth of invasion, lymphovascular space invasion, FIGO stage, grade, histology, as well as 21 Markov parameters. DI and the Markov parameters were quantified using image analysis. RESULTS: Median follow-up for the study population was 31 months with a range from 1 to 44 months. Fifteen patients had recurrence of their cancer and 12 patients died from disease during the observation period of the study. Eleven Markov parameters showed significant correlation with increasing FIGO stage (P < 0.05), while 14 Markov parameters showed significant correlation with survival (P < 0.05). Three Markov parameters, difference entropy (P = 0.025), information measure B (P = 0.01), and diagonal moment (P = 0.046), were demonstrated to be independent prognostic indicators along with the more traditional prognostic indicators, stage (P = 0.006), grade (P = 0.029), and depth of myometrial invasion (P = 0.03). CONCLUSION: Image analysis is able to quantify optical texture. Utilizing bivariate correlations and multivariate analysis, three of these parameters were demonstrated to be independent prognostic indicators in endometrial cancer, specifically difference entropy, information measure B, and diagonal moment.

Adult↗

PubMed1996

Relationship of preoperative serum CA-125 to survival in epithelial ovarian carcinoma.

BACKGROUND: Epithelial carcinoma of the ovary has the highest death rate of any gynecologic malignancy in the developed world. The antigen CA-125 has been used over the past decade as a tumor marker for epithelial ovarian cancer and other cancers of coelomic epithelium. The object of this study was to see if the degree of elevation of preoperative CA-125 was related to length of survival in patients with epithelial ovarian carcinoma. METHODS: Eighty-two consecutive patients diagnosed with epithelial ovarian carcinoma were evaluated for their initial preoperative CA-125 level, time to recurrence, length of survival and level of primary debulking as well as International Federation of Gynecologists and Obstetricians stage, grade and histology. Ovarian tumors of low malignant potential were not included in the study. All patients had their initial surgery performed by one surgeon. RESULTS: Decreased length of survival was related to the degree of elevation of CA-125 prior to initial exploratory laparotomy (P = .047). The mean initial CA-125 for patients surviving five years or more (15 patients) was 899 U/mL, with an SD of +/- 1,880 U/mL, while the CA-125 for patients surviving less than five years (67 patients) was 1,978 U/mL, with an SD of +/- 1,852 U/mL (P = .02). Increased stage of disease at initial laparotomy showed a relationship to increased CA-125 (P < .0001). CONCLUSION: In epithelial ovarian carcinoma, high preoperative serum levels of CA-125 predict decreased length of survival.

Biomarkers, Tumor↗

PubMed1996

Using FIGO histologic grade to determine when to perform lymphadenectomies in endometrioid adenocarcinoma of the endometrium.

PURPOSE: Controversy remains as to whether selective pelvic and periaortic lymphadenectomies should be performed in low grade (grade 1 or 2) endometrioid endometrial cancer. The authors reviewed their experience over the last three years in their population of endometrioid adenocarcinomas of the endometrium to see if lymphadenectomies were necessary in low grade malignancies. METHODS: The records of all patients with endometrioid adenocarcinoma of the endometrium undergoing primary surgery by the gynecologic oncology service between November 1, 1991, and August 31, 1994, were analyzed for age, FIGO stage, grade, histologic type, lymphovascular space invasion, peritoneal cytology, and time to recurrence. RESULTS: Sixty-five patients with endometrioid adenocarcinoma of the endometrium were found. Twenty-five had grade I disease, 31, grade 2 disease, and 9, grade 3. Forty-seven patients had stage I disease, 5 stage II disease, 12 stage III disease and 1, stage IV disease. No patient with grade 1 disease had positive lymph nodes on examination. Six with grade 2 (19.4%) and two (22.2%) with grade 3 disease had positive lymph nodes. The percentage of patients with positive lymph nodes was not significantly different between those with grade 2 and 3 disease (p = 0.86) but was significantly different between grade 2 or 3 and grade 1 (p = 0.021) (p = 0.017). CONCLUSION: Pelvic and periaortic lymphadenectomies should be performed as part of standard surgical therapy in patients with FIGO grade 2 endometrioid adenocarcinomas of the endometrium. The decision as to whether to perform lymphadenectomies in grade 1 tumors must be left to the discretion of the surgeon since a chance exists that a higher grade or more deeply invasive tumor may be found on final pathological diagnosis.

Adenocarcinoma↗

PubMed1995

Estrogen and progesterone receptors in malignant mixed mesodermal tumors of the ovary.

Malignant mixed mesodermal tumors of the ovary occur in less than 1% of cases of ovarian cancer. They have a dismal prognosis and the most effective type of therapy is still not known. All cases of malignant mixed mesodermal tumor of the ovary between January 1, 1985 and May 1, 1994 operated on by the gynecologic oncology service are the subject of this report. Data were obtained from the hospital and office records of the patients. Nine patients who had their primary surgery by the gynecologic oncology service were found to have the diagnosis of malignant mixed mesodermal tumor of the ovary. Homologous tumors were found in five patients and heterologous tumors in four. Homologous tumors (mean survival 15.2 months) showed a better survival than heterologous tumors (mean survival 6.5 months; P = 0.001). An elevated estrogen receptor status was shown to correspond to longer survival (P < 0.0001). Six specimens were considered to be estrogen receptor positive and three were receptor negative. The mean survival in those patients who had a positive estrogen receptor status, 13.7 months, with a median of 7.5 months was significantly higher than those who were not positive, 6.7 months (P = 0.019) with a median of 6.25 months. All specimens were progesterone receptor negative. Malignant mixed mesodermal tumors of the ovary have a dismal prognosis, no effective therapy, and controversial prognostic indicators. Increasing estrogen receptor status appeared to correlate with longer mean survival. Larger, multi-institutional studies need to be done to determine the overall significance of these findings.

Female↗

PubMed1995

Extramammary Paget's disease of the vulva recurring in a skin graft.

Extramammary Paget's disease of the vulva is an uncommon vulvar neoplasm with a high rate of recurrence. A 64-year-old white female with a history of extramammary Paget's disease of the vulva, excised in 1987 by skinning vulvectomy and treated again in 1993 by skinning vulvectomy with split-thickness skin grafting, presented in 1994 with recurrent Paget's disease in the area of the skin graft. Extramammary Paget's disease of the vulva may recur in an area previously totally excised and transplanted with autologous skin. Therefore, close follow-up is necessary in all patients with this pathologic entity.

Female↗