Paget's disease of the vulva: evaluation of recurrence relative to symptom duration, volumetric excision of lesion, and surgical margin status.

We analyzed recurrences with regard to symptom duration, volumetric excision, and surgical margin in 11 women with Paget's disease of the vulva. Data concerning demographics, surgical margin, and current state were collected. In addition, the three-dimensional excisional skin and lesion size was determined from surgical and pathology reports. Recurrence was observed in 6 women where the symptom duration was longer than in those without recurrence (33 vs. 11 months, p < 0.02). During the initial operation, the fraction of removed normal skin was 85.3% in all the women, and 79.8% (range 67-97%) in those with recurrence and 92.0% (range 86-96%) in those without (p < 0.04). Of 11 women, 8 had positive margins of whom 4 developed recurrence and 4 did not. Of the 3 patients with negative margins, 2 experienced recurrence but the third did not (p = 0.58). Recurrence was not associated with positive margins, but correlated with symptom duration and volumetric excision.