A Systematic Review and Meta-Analysis of Mapping Biopsy for Primary Extramammary Paget’s Disease in Reducing Recurrence Following Surgical Excision
| Title: | A Systematic Review and Meta-Analysis of Mapping Biopsy for Primary Extramammary Paget’s Disease in Reducing Recurrence Following Surgical Excision |
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| Authors: | Thirrisha Murugan, Louis Choon Kit Wong, MD, Xing-Yi Sarah Ong, MD, Sze Huey Tan, PhD, Joey Wee-Shan Tan, MSc, Ying Liu, PhD, Nicholas B. Shannon, PhD, MD, Jianbang Chiang, MBBS, MRCP, MMed, Eileen Poon, MBBS, MRCP, MMED, Jason Yongsheng Chan, MBBS, MRCP, MMed, FAMS, PhD, Valerie Shiwen Yang, MB BChir, PhD, MRCP, FAMS, Nagavalli Somasundaram, MBBS, MRCP, MMED, Mohamad Farid, MBBS, MRCP, MMed, Ru Xin Wong, MBBS, FRCR, Wen Long Nei, MBBS, FRCR, Jin Wei Kwek, MBBS, FRCR, FAMS, Choon Hua Thng, MBBS, FRCR, FAMS, Tiffany Hennedige, MBBS, FRCR, MMed, MCI, Po Yin Tang, BMEDSc, MBBS, FRCPath, FRCAPA, Sathiyamoorthy Selvarajan, MBBS, PGDCP, FRCPath, MCS, FAMS, Kae Jack Tay, MBBS, MRCS, MMed, MCI, FAMS, Mohamed Rezal Abdul, MB, BCh, BAO, LRCP&SI, MSurg, Jolene Si Min Wong, MBBS, MMed, FRCS, Chin Jin Seo, MB, BCh, BAO, MMed, FRCS, Khee Chee Soo, MBBS, MD, FRACS, FACS, Claramae Shulyn Chia, MBBS, MMed, FRCS, Chin-Ann Johnny Ong, MBBS, MMed, FRCS, PhD |
| Source: | Annals of Surgery Open, Vol 4, Iss 4, p e339 (2023) |
| Publisher Information: | Wolters Kluwer Health, 2023. |
| Publication Year: | 2023 |
| Collection: | LCC:Surgery |
| Subject Terms: | Surgery, RD1-811 |
| More Details: | Objective:. To examine the association between the performance of mapping biopsies and surgical outcomes postexcision of extramammary Paget’s disease (EMPD). Background:. Primary EMPD is a rare entity associated with poorly defined surgical margins and difficult-to-access sites of lesions. Surgical resection with clear margins remains the preferred management method. The use of mapping biopsies might be beneficial, particularly in lowering disease recurrence. Methods:. Available literature was reviewed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology before a fixed-effect meta-analysis was performed to identify the presence of a correlation between performing mapping biopsies and positive margins on permanent sections as well as disease-free survival. Additional study results not included in the quantitative assessment were qualitatively assessed and reported. Results:. A total of 12 studies were shortlisted for final analysis. 294 patients who underwent mapping biopsies and 48 patients who did not undergo mapping biopsies were included in the assessment. Forest plot analysis revealed a pooled rate ratio of 0.50 (95% CI, 0.32–0.77) in the prevalence of positive margins in patients with mapping biopsies performed as compared to patients without. The pooled rate ratio of the prevalence of disease-free survival in patients with mapping biopsies performed as compared to patients without was 1.38 (95% CI, 1.03–1.84). Qualitative assessment of the remaining selected studies revealed equivocal results. Conclusions:. Mapping biopsies are able to improve EMPD surgical excision outcomes but given the rarity of the disease and heterogeneity of mapping biopsy procedures, further confirmation with randomized controlled trials or a larger patient pool is necessary. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 2691-3593 00000000 |
| Relation: | http://journals.lww.com/10.1097/AS9.0000000000000339; https://doaj.org/toc/2691-3593 |
| DOI: | 10.1097/AS9.0000000000000339 |
| Access URL: | https://doaj.org/article/589c0f67ac2448b1839449eb040494f7 |
| Accession Number: | edsdoj.589c0f67ac2448b1839449eb040494f7 |
| Database: | Directory of Open Access Journals |
| ISSN: | 26913593 00000000 |
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| DOI: | 10.1097/AS9.0000000000000339 |
| Published in: | Annals of Surgery Open |
| Language: | English |