Clinicopathological Characteristics and Outcomes of Anal Squamous Cell Carcinoma Patients With and Without HIV Infection in Sub-Saharan Africa.
Clinicopathological Characteristics and Outcomes of Anal Squamous Cell Carcinoma Patients With and Without HIV Infection in Sub-Saharan Africa.
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DOI：
10.1200/go.22.00394
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发表时间：
2023-05
影响因子：
4.5
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中科院分区：
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过去 20 年来，美国肛门癌 (AC) 的负担增加了 60%，非洲增加了三倍多。 HIV 感染者的 AC 发生率增加了 20 倍，而与男性发生性关系的男性 HIV 感染者的 AC 发生率最高 (50 倍)。然而，在艾滋病毒流行的撒哈拉以南非洲 (SSA)，缺乏有关 AC 患者的临床病理特征和结果的数据。为了解决这个问题，我们在 SSA 中感染 HIV 或未感染 HIV 的一组患者中调查了 AC 疾病表现、治疗结果及其预测因素。我们对 2014 年 1 月至 2019 年 12 月在坦桑尼亚达累斯萨拉姆大洋路癌症研究所接受治疗的肛门鳞状细胞癌 (SCC) 患者进行了一项回顾性队列研究。使用单变量和多变量分析模型分析了研究结果与其预测因素之间的关联。总共回收了 59 名肛门 SCC 患者，并进行了至少 2 年的随访。平均年龄为 53.9（标准差±10.5）岁。虽然没有患者出现 I 期疾病，但 64.4% 的患者患有局部晚期疾病。 HIV感染是主要合并症（64.4%）。治疗结束时完全缓解率为49%，2年总生存率（OS）和局部无复发生存率分别为86.4%和91.3%。尽管队列中 HIV 合并感染率较高，但 AC 治疗结果与 HIV 状况并无显着相关性。疾病分期 (P = .012) 和分级 (P = .030) 与 2 年 OS 显着相关。坦桑尼亚的肛门鳞状细胞癌患者主要患有与艾滋病毒高流行相关的局部晚期疾病。在该队列中，与 HIV 合并感染等其他因素不同，SCC 等级与治疗结果独立相关。
In the past 20 years, the burden of anal cancer (AC) increased by 60% in the United States and over three-fold in Africa. Rates of AC have increased by 20× in people living with HIV and the highest (50×) in men with HIV who have sex with men. However, in sub-Saharan Africa (SSA) where HIV is endemic, data on clinicopathological characteristics and outcomes of patients with AC are lacking. To address this, we have investigated AC disease presentation, treatment outcomes, and its predictors in a cohort of patients who were either HIV-infected or HIV-uninfected in SSA. We conducted a retrospective cohort study of patients with anal squamous cell carcinoma (SCC) treated at Ocean Road Cancer Institute in Dar es Salaam, Tanzania from January 2014 to December 2019. Associations between the study outcomes and their predictors were analyzed using univariate and multivariate analysis models. A total of 59 patients with anal SCC were retrieved and had at least 2-year follow-up. The mean age was 53.9 (standard deviation ±10.5) years. While none of the patients presented with stage I disease, 64.4% had locally advanced disease. HIV infection was the major comorbidity (64.4%). The rate of complete remission at the end of treatment was at 49% while the 2-year overall survival (OS) and local recurrence-free survival were 86.4% and 91.3%, respectively. Despite high HIV coinfection in the cohort, AC treatment outcomes were not significantly associated with HIV status. Disease stage (P = .012) and grade (P = .030) were significantly associated with 2-year OS. Patients with anal SCC in Tanzania present mainly with locally advanced disease associated with high HIV prevalence. In this cohort, the SCC grade was independently associated with treatment outcomes unlike other factors such as HIV coinfection.
影响因子：
1.4
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