Revista da Associação Médica Brasileira
versão impressa ISSN 0104-4230
NADAL, Sidney Roberto; HORTA, Sergio Henrique Couto; CALORE, Edenilson Eduardo e MANZIONE, Carmen Ruth. Outcome of treatment of anal squamous cell carcinoma and its precursor in HIV-infected patients. Rev. Assoc. Med. Bras. [online]. 2007, vol.53, n.4, pp. 365-369. ISSN 0104-4230. http://dx.doi.org/10.1590/S0104-42302007000400025.
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. CONCLUSION: 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.
Palavras-chave : Carcinoma; squamous cell; Radiotherapy; Drug Therapy; Carcinoma in situ; Papillomavirus infections; Aids.