Clinical presentation and outcome of squamous cell carcinoma of the anus in HIV-infected patients in the HAART-era: a GICAT experience

INTRODUCTION: Squamous cell carcinoma of the anus (SCCA) is a relatively uncommoncancer. In the HIV-positive patients the introduction of the highly activeantiretroviral therapy (HAART) did not change the incidence of SCCA.BACKGROUND AND OBJECTIVES: This paper describes the Italian Cooperative Group on AIDS and Tumours (GICAT) experience on HIV-positive patients with SCCA. Thepurposes of this retrospective study were: first to describe the clinicalpresentation and outcome of HIV-positive patients with SCCA, second to comparethem with the ones reported in the literature.PATIENTS AND METHODS: Between July 2000 and March 2010 we retrospectivelycollected epidemiological, clinical and survival data from 65 patients with SCCA in HIV infection enrolled within the GICAT.RESULTS: Fifty-three (81.5%) patients were male. The majority of patients (40%)were homosexual Forty-three patients (66.1%) were diagnosed with HIV before 1996.Thirty-five patients (54%) had CD4-positive cells count > 200 / mm3 and 28patients (43%) had viral load > 50 cp / ml at the time of SCCA diagnosis. Themedian time difference between HIV and SCCA diagnosis was 120 months (range10-282 months). Sixty-one patients (96.8%) received HAART at SCCA diagnosis.Fifty-two patients (80%) had performance status (PS) 0-1 at the time of SCCAdiagnosis. Twenty-seven patients (41.5%) underwent surgery with curative intent. Thirty-five patients (53.9%) were given combined modality therapy (CMT)consisting of pelvic radiotherapy with concurrent chemotherapy. No grade 3/4haematological or extra-haematological effects were observed in our patients.CONCLUSIONS: In summary, despite the retrospective nature of analysis, theabsence of patient strict criteria of inclusion/exclusion, our data onHIV-positive patients with SCCA, compared both to general population and to smallreports on HIV-positive patients present in the literature, are promising.