Clinical characteristics and survival outcomes of perianal Paget’s disease:A SEER population-based study

Objective The aim of the study was to analyze the clinical features of patients with perianal Paget’s disease (PPD) and investigate prognosis risk factors.Methods The SEER*Stat software was used to identify 116 PPD patients from 1975 to 2015 in the SEER research database.The Kaplan-Meier method was used to conduct a univariate analysis for PPD patients.The differences in survival rates were evaluated using the log-rank test.The differences in the clinicopathological features of PPD patients with or without anorectal carcinoma were compared using the chi-square test.Results The median survival time of PPD patients was 44 months.The median age of onset was 73 years old.The 43.10% of the patients were alive at the end of follow up,and only 12.93% of the patients died of PPD.Elderly (age > 70 years;χ2=9.453,P=0.002),poor differentiation (χ2=46.557,P=0.000) and abdominal perineal resection (APR;χ2=46.557,P=0.000) were unfavorable risk factors of prognosis.Nearly 50% of PPD had combined with other malignancies,and over 22.41% of those had multiple primary neoplasms (3 or more).PPDs predisposed concurrent malignancy,and 48.21% of PPD patients with other malignancies combined with anorectal carcinoma in the study.Stage (χ2=10.127,P=0.018),and surgical method (χ2=12.245,P=0.007) were statistically significant in the PPD patients with or without anorectal carcinoma.The 16.07% of patients had multiple lesions of Paget’s.Conclusion Patients with PPD have a favorable survival,while the disease-specific mortality is low.Diagnosed age,differentiation,and surgical methods were the influence factors of prognosis in PPD patients.PPDs with anorectal carcinoma is of most important in further investigation.