title: Extensive anal condylomatosis: prognosis in relation to viral and host factors.
abstract: OBJECTIVE
  To evaluate the clinical course of extensive anal condylomatosis in relation to treatment modalities, patient comorbidity and immune function, and associated papillomavirus (HPV) sequences.
  
  
  METHODS
  Clinical data, treatment modalities and follow-up were recorded and analysed in relation to host and viral type. Histology, immunohistochemistry and molecular analyses for HPV search and typing were performed on formalin-fixed paraffin-embedded samples.
  
  
  RESULTS
  Sixteen patients [14 males, median age 41.8 years (range 19-66)] affected by extensive anal condylomatosis [10 Buschke-Lowenstein Tumors (BLT) and 6 condylomatosis] treated in three different Italian institutions were included. There was associated preoperative anal intraepithelial neoplasia grade 3 (AIN3) in one and invasive carcinoma in three patients. After radical resection (n = 16) recurrence occurred in 4/10 (40%) BLT patients. Malignancy before or after treatment developed in 5/16 (31.25%) patients. HPV sequences were present in all the samples of 15 evaluable patients (types 6 or 11, 9 patients; type 16, 6 patients). A statistically significant association was found between presence of HPV type 16 and both malignancy and recurrence. Viral variant L83V was present in 3/4 HPV 16 positive recurrent cases.
  
  
  CONCLUSIONS
  Radical resection resulted in a favourable clinical course. Typing of HPV sequences in the management of patients affected by extensive anal condylomatosis may be useful.
authors.affiliation: Dipartimento di Scienze Chirurgiche e Gastroenterologiche, Clinica Chirurgica III, Unità di Chirurgia Colo-Proctologica, Università di Padova, Padova, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Sarzo
authors.forename: A
authors.initials: A
authors.lastname: Del Mistro
authors.forename: A
authors.initials: A
authors.lastname: Mistro
authors.forename: C
authors.initials: C
authors.lastname: Finco
authors.forename: H
authors.initials: H
authors.lastname: Frayle-Salamanca
authors.forename: F
authors.initials: F
authors.lastname: Marino
authors.forename: M
authors.initials: M
authors.lastname: Franzetti
authors.forename: R
authors.initials: R
authors.lastname: Ferrara
authors.forename: M
authors.initials: M
authors.lastname: Mistrangelo
authors.forename: S
authors.initials: S
authors.lastname: Savastano
authors.forename: M
authors.initials: M
authors.lastname: Vecchiato
authors.forename: S
authors.initials: S
authors.lastname: Merigliano
mesh_terms: D000328:Adult; D000368:Aged; D003082:Colectomy / Q000379:methods*; D003218:Condylomata Acuminata / Q000175:diagnosis / Q000601:surgery / Q000821:virology*; D004279:DNA, Viral / Q000032:analysis*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006678:HIV / Q000235:genetics*; D006518:Hepatitis Viruses / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011349:Proctitis / Q000175:diagnosis / Q000601:surgery / Q000821:virology*; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D004279:DNA, Viral