title: [Outcome of treatment of anal squamous cell carcinoma and its precursor in HIV-infected patients].
abstract: OBJECTIVE
  Incidence of anal squamous cell carcinoma is increasing mainly among HIV-positive patients. Treatment consists of radiotherapy and chemotherapy, sometimes followed by tumor resection. The objective was to evaluate the follow-up of such patients to verify recurrences and evolution from HAIN to cancer. This is a report of cases treated at the "Instituto de Infectologia Emílio Ribas", Sao Paulo, Brazil.
  
  
  METHODS
  We attended 45 HIV-positive patients between July 1996 and June 2006. Most were male (97.7%), with ages ranging from 23 to 55 years (mean: 38.5 years). Thirty patients had high grade anal intra-epithelial neoplasia (HAIN), treated with local resection, and 15 with anal canal invasive squamous cell carcinoma were first submitted to chemo radiation, while biopsies were obtained during follow-up.
  
  
  RESULTS
  Patients with HAIN had recurrences in 16.7% of cases and remained cancer free for up to five years. Chemoradiation was not possible in five patients with invasive carcinoma (40%) because three had advanced AIDS and two refused treatment. Eight (88.8%) out of nine patients had complete response to chemoradiation and remained cancer free for a period from three to six years. Chemoradiation failed in the ninth patient: abdominal perineal resection was performed, and there was no recurrence over a five-year period.
  
  
  CONCLUSIONS
  We concluded that HAIN can recur after local resection in HIV-positive patients but does not evolve to invasive carcinoma. Invasive cancer can be treated in the same way as in HIV seronegative persons, when clinical conditions permit.
authors.affiliation: Instituto de Infectologia Emilio Ribas, São Paulo, Brazil. srnadal@terra.com.br
authors.forename: Sidney Roberto
authors.initials: SR
authors.lastname: Nadal
authors.forename: Sergio Henrique Couto
authors.initials: SH
authors.lastname: Horta
authors.forename: Edenilson Eduardo
authors.initials: EE
authors.lastname: Calore
authors.forename: Carmen Ruth
authors.initials: CR
authors.lastname: Manzione
mesh_terms: D000328:Adult; D001005:Anus Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy*; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006679:HIV Seropositivity; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D017211:Treatment Failure; D016896:Treatment Outcome; D016312:Treatment Refusal / Q000706:statistics & numerical data