Prognostic
and predictive clinicopathologic factors of squamous anal canal cancer in
HIV-positive and HIV-negative patients: Does HAART influence outcomes?
Pappou EP, et
al. - Researchers aimed at delineating outcomes of anal squamous cell carcinoma
(SCC) treatment in HIV-positive and human immunodeficiency virus (HIV)-negative
patients. They observed that among patients with anal SCC, HIV infection was
not associated with a significantly higher relapse rate or worse 5-year overall
survival. A higher rate of relapse was evident in association with highly
active antiretroviral therapy (HAART) in HIV-positive patients. Regardless of
HIV status, AJCC staging predicted survival in both relapsed and non-relapsed
patients.
Methods
• Researchers performed a retrospective
single-institution analysis on all patients with anal SCC treated at the JohnsHopkins Hospital between 1991 and 2010.
• Five-year overall survival (5-year
OS), median survival, and relapse rates were the primary outcome measures.
Results
• Ninety-three patients with anal SCC
were identified (mean age was 54 years; 37.6% were male, and 21.5% were HIV-positive).
• Patients were followed-up for a
median period of 28 months.
• In 16.1% of patients, relapse
occurred; median time was 20 months.
• With HIV-positive vs negative
patients, relapse rates were slightly higher (30.0 vs 12.3%), however, the
difference did not reach statistical significance (p=0.06).
• Patients who relapsed were more
likely to be on HAART than those who did not relapse (83.3 vs 14.3%, p=0.007)
among HIV-positive patients.
• For the total group of patients,
5-year OS was 58.9%; no significant difference was evident between those who
relapsed vs those who did not (76.2 vs 54.5%, p=0.20).
• HIV-positive and negative patients
showed no survival difference.
• In all patients, survival was
associated with AJCC stage.
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