Lymphangiogenesis is a Predictor of Nodal Metastasis in Extramammary Paget's Disease

Aims: The depth of dermal invasion, lymphatic invasion and tumour formation are thought to be predictors of nodal metastasis in extramammary Paget's disease (EPD). This study investigated the relationship between lymphangiogenesis and nodal metastasis in EPD.

Methods And Results: Fifty cases (12 females and 38 males) with primary EPD of the external genitalia whounderwent surgical resection were studied. In 23 cases, inguinal lymph node dissection was performed, and nodal metastasis was found in eight cases. Lymphatic invasion and lymphangiogenesis were evaluated by D2-40 immunostain. Lymphangiogenesis was observed in 25 cases (50%). There were significant differences in the presence or absence of dermal invasion, depth of invasion, lymphatic invasion and nodal metastasis between the lymphangiogenesis group and non-lymphangiogenesis group.

Conclusion: Dermal invasion and depth of dermal invasion are predictors for nodal metastasis in EPD. However, in the current study, we demonstrate that lymphangiogenesis is also a predictor of nodal metastasis in EPD.