Anal Squamous Cell Carcinoma in the HIV-Positive Patient

AbstractAnal Squamous Cell Carcinoma (ASCC) is a rare cancer that has a rapidly increasing incidence in areas with highly developed economies. ASCC is strongly associated with HIV and there appears to be increasing numbers of younger male persons living with HIV (PLWH) diagnosed with ASCC. This is a retrospective cohort study of HIV positive and HIV negative patients diagnosed with primary ASCC between January 2000 and January 2020 in a demographic group with high prevalence rates of HIV. One Hundred and seventy six patients were included, and clinical data was retrieved from multiple, prospective databases. A clinical subgroup was identified in this cohort of younger HIV positive males who were more likely to have had a prior diagnosis of Anal Intraepithelial Neoplasia (AIN). Gender and HIV status had no effect on staging or disease-free survival. PLWH were more likely to develop a recurrence (p < 0.000) but had a longer time to recurrence than HIV negative patients, however this was not statistically significant (46.1 months vs. 17.5 months; p = 0.077). Patients known to have a previous diagnosis of AIN were more likely to have earlier staging and local tumour excision. Five-year Disease-Free Survival was associated with tumour size and the absence of nodal or metastatic disease (p < 0.000).

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Gemella morbillorumisolated from a pelvic abscess in an HIV-positive patient with squamous cell carcinoma of the perianal region

BMJ Case Reports ◽

10.1136/bcr-2018-227352 ◽

2019 ◽

Vol 12 (5) ◽

pp. e227352 ◽

Cited By ~ 1

Author(s):

Benjamin Edward Ueberroth ◽

Renato Roxas

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Pelvic Abscess ◽

Positive Patient ◽

Hiv Positive ◽

Perianal Region ◽

The Past ◽

Initial Improvement ◽

Time Of Admission

Gemella morbillorumis a known commensal organism of the human oropharynx, gastrointestinal tract and genitourinary tract which is a rare cause of infections and even more rarely implicated in skin and soft tissue infections. We present a case of a young, HIV-positive patient with squamous cell carcinoma of the perianal region who presented with difficulty initiating urination for 1 week as well as increasing left leg swelling. His CD4 count was found to be 186, predisposing him to infection, and he had also received chemotherapy in the past year for his malignancy. He was febrile and tachycardic on presentation and admitted for further care. CT scan of the pelvis at time of admission demonstrated a pelvic abscess. Aspiration cultures ultimately grewG. morbillorum.Despite initial improvement with drainage and targeted antimicrobial therapy, the patient’s abscess recurred, and he ultimately elected transition to hospice due to worsening prognosis of malignancy.

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Salvage Surgery for Residual Primary and Locally Recurrent Anal Squamous Cell Carcinoma After Chemoradiotherapy in HIV-positive Individuals

Annals of Surgical Oncology ◽

10.1245/s10434-013-3353-3 ◽

2013 ◽

Vol 21 (2) ◽

pp. 527-532 ◽

Cited By ~ 10

Author(s):

Laila Cunin ◽

M. Alfa-Wali ◽

J. Turner ◽

M. Bower ◽

L. Ion ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Salvage Surgery ◽

Hiv Positive ◽

Anal Squamous Cell Carcinoma ◽

Locally Recurrent

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Outcome analysis of HIV-positive patients with anal squamous cell carcinoma

Diseases of the Colon & Rectum ◽

10.1007/bf02234322 ◽

2001 ◽

Vol 44 (4) ◽

pp. 506-512 ◽

Cited By ~ 61

Author(s):

Ronald J. Place ◽

Sharon G. Gregorcyk ◽

Philip J. Huber ◽

Clifford L. Simmang

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Outcome Analysis ◽

Hiv Positive ◽

Anal Squamous Cell Carcinoma

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A case of tongue squamous cell carcinoma in an HIV-positive patient successfully treated with radical surgery and postoperative radiation

Journal of Japanese Society of Oral Oncology ◽

10.5843/jsot.23.161 ◽

2011 ◽

Vol 23 (4) ◽

pp. 161-166

Author(s):

Takeshi Koike ◽

Takahiro Kamata ◽

Shigeru Suzuki ◽

Tetsu Shimane ◽

Hiroichi Kobayashi ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Radical Surgery ◽

Tongue Squamous Cell Carcinoma ◽

Positive Patient ◽

Hiv Positive ◽

Postoperative Radiation

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Low dose mitomycin c, capecitabine & radiation for HIV patients with anal squamous cell carcinoma

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.14148 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 14148-14148

Author(s):

R. Wadleigh ◽

K. Dinh ◽

J. Manning ◽

A. Kuntz ◽

R. Dorn

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Mitomycin C ◽

Squamous Cell ◽

Low Dose ◽

Disease Free Survival ◽

Hiv Positive ◽

Hematologic Toxicity ◽

Anal Squamous Cell Carcinoma ◽

Flat Dose

14148 Background: Chemoradiotherapy has replaced radical surgery as the initial treatment of choice for anal squamous cell carcinoma (ASCC). Optimal chemotherapy regimen for ASCC in HIV positive patients is not yet defined. The addition of mitomycin C to 5-FU and radiotherapy in the past improves local control, colostomy-free, and even disease-free survival in large tumors. The concern is hematologic toxicity if use in HIV positive patients. We report 2 cases safely using low dose mitomycin C, capecitabine and concurrent XRT. One of these patients has ESRD, which the use of cisplatin is not an option. Methods: 2 HIV positive patients, (CD4 range 106–113, at diagnosis of ASCC) were treated with low dose of mitomycin C on day 1 for 2 cycles (5mg flat dose), day 1–7 capecitabine titrated up to 1.5 gm/m2 divided b.i.d, and concurrent XRT (total dose 5040 cGy). Prior to treatment, 1 patient was diagnosed with squamous cell carcinoma in-situ and the other with stage 1 squamous cell carcinoma. 1 patient has end stage renal disease with SCr between 10 and 12 mg/dl at the time of treatment. Results: Both patients completed treatment. No grade 3 or 4 hematologic or gastrointestinal toxicities were noted. No hand-foot syndrome was observed probably due to low dose of capecitabine. Both patients are still alive and remain in remission (16–18 months post treatment). Conclusions: Our 2 cases suggest that the use of low dose mitomycin C in addition to capecitabine and XRT is well tolerated and is efficacious in HIV-positive patients with ASCC. No significant financial relationships to disclose.

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A retrospective review of anal squamous cell carcinoma in HIV positive and HIV negative patients

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.4153 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 4153-4153 ◽

Cited By ~ 3

Author(s):

J. Grandhi ◽

P. A. Philip ◽

T. Washington ◽

A. F. Shields ◽

U. Vaishampayan ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Anal Cancer ◽

Squamous Cell ◽

Case Series ◽

Response To Treatment ◽

Hiv Positive ◽

Stage At Diagnosis ◽

Anal Squamous Cell Carcinoma ◽

Hiv Negative

4153 Background: The incidence of invasive anal cancer is 120 times higher in the HIV infected patients than in the general population. The outcome of anal cancer in HIV infected patients has not been evaluated in prospective trials and the published literature is limited to small retrospective case series. The aim of this study is to describe the outcome, tolerability, event free survival, and overall survival in patients with squamous cell carcinoma of anal canal (SCCAC) with and without HIV infection treated at Karmanos Cancer Institute/Wayne State University from 1991 to 2005. Methods: We performed a retrospective chart review. Patients were identified using the SEER database. We collected data regarding HIV status, demographics (age, gender, race), stage at diagnosis, treatment, response to treatment, toxicity and survival. Results: Forty patients with SCCAC were identified, of which 13 were HIV positive and 27 were HIV negative. The HIV-positive and HIV-negative groups differed by mean age (44 vs. 55 years), male gender (100 vs. 37 percent), and African American race (92 vs. 59 percent). There were no differences in stage at diagnosis, type of chemotherapy received. HIV positive population received reduced chemotherapy (67 vs. 8 percent), and RT (22 vs. 7 percent) dosage. The major toxicities observed in HIV positive and negative patients were mucositis (23% vs. 29%), neutropenia (8% vs. 33%) and skin toxicity (46% vs. 55%) secondary to radiotherapy. Only 61 percent of HIV-positive patients were disease free vs. 60 percent of HIV-negative patients. Conclusions: We found that HIV positive patients received lower doses of chemo-radiotherapy. Patients with HIV tolerated the lower dose chemoradiotherapy and had a similar toxicity profile to the HIV negative patients. No major difference in the risk of recurrence between HIV positive and negative patients was observed. No significant financial relationships to disclose.

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