[Anal canal squamous-cell carcinomas in HIV positive patients: clinical features, treatments and prognosis].
The prevalence of squamous-cell carcinoma of the anus seems to be increasing in HIV positive patients. Clinical features and prognosis in this population have not been well evaluated.


OBJECTIVE
To assess the prognosis of anal squamous-cell carcinoma in HIV positive patients as well as clinical features and treatment procedures.


METHODS
A series of 20 HIV positive patients presenting with invasive anal squamous-cell carcinoma was retrospectively analyzed. Data have been compared to those obtained from 24 randomly selected HIV negative patients who were followed during the same periods in the same centers for anal carcinoma with similar histopathological features.


RESULTS
The follow-up ranged from 10 to 172 months. No difference was observed between the two groups concerning the clinical features leading to anal cancer diagnosis, although HIV positive patients were younger. Anal cancer was more frequently associated with lymph node metastasis in HIV positive (60%) than in HIV negative (17%) patients, although its size was similar in both groups. Radiotherapy was similarly performed in both groups, while chemotherapy was administered less frequently in HIV positive than in HIV negative patients (54% vs 25%). Immediate side effects and mortality at 1 year follow-up were similar in both groups, whereas the objective initial response to therapy (50% versus 88%), the remission rate with anal conservation at 1 year follow-up (45% versus 88%), and the mortality at 3 years were better in HIV negative patients.


CONCLUSIONS
The prognosis of anal squamous-cell carcinoma is poor in HIV positive patients. This correlates with a more advanced tumor stage and an alteration of systemic immunity status at the time of diagnosis and less response rate to treatment. Detection of precancerous lesions and treatment procedures should be evaluated in HIV infected patients.
Vatra
Bogdan
B
FAMA de Colo-Proctologie, Hôpital Bichat-Claude Bernard, Paris, France.
Sobhani
Iradj
I
Aparicio
Thomas
T
Girard
Pierre-Marie
PM
Puy Montbrun
Thierry Du
TD
Housset
Martin
M
Baillet
François
F
Hecht
Franck
F
Chossidow
Denis
D
Soulé
Jean-Claude
JC
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001005:Anus Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006679:HIV Seropositivity / Q000150:complications*; D006716:Homosexuality; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011878:Radiotherapy; D013514:Surgical Procedures, Operative; D016896:Treatment Outcome
D000970:Antineoplastic Agents
Caractéristiques cliniques, thérapeutiques et pronostiques des carcinomes épidermoïdes du canal anal chez les malades VIH positifs.