Surgical excision alone for stage T1 anal verge cancers in people living with HIV.

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Title: Surgical excision alone for stage T1 anal verge cancers in people living with HIV.
Author(s): Alfa-Wali, M
Dalla Pria, A
Nelson, M
Tekkis, P
Bower, M
Item Type: Journal Article
Abstract: INTRODUCTION: Anal cancer accounts for a small percentage of colorectal malignancies. Early stage (T1N0M0) cancers of the anal verge have been treated with local surgical excision alone in individuals without human immunodeficiency virus (HIV) infection. The risk of anal cancer is higher in people living with HIV (PLWH). We present results of the outcomes of T1 anal verge cancers treated by local excision only in a series of PLWH. METHODS: Demographic and clinicopathological data was prospectively collected from all HIV positive individuals with anal cancer, treated between 1986 and 2015. The date from anal cancer diagnosis until the date of the last follow up were collected. RESULTS: Fifteen patients had T1N0M0 cancer of the anal verge from a total of 92 patients with HIV-associated anal cancer. The mean age was 49 years (range 36-57). The average age of HIV diagnosis was 35 years (range 19-48) and four patients had a diagnosis of AIDS prior to the diagnosis of anal cancer. All patients were surgically managed with complete local excision of the tumour. There were no complications or need for any adjuvant therapy. No patients have relapsed and at a median follow up of 4 years (range 3-15), the overall survival was 100%. CONCLUSION: Surgical resection for early stage anal verge cancers is an effective strategy in PLWH. Increasing awareness of anal cancer and anoscopy surveillance in PLWH will hopefully continue to identify anal cancers at an early stage that are amenable to minimally invasive surgical management.
Publication Date: 11-Mar-2016
Date of Acceptance: 23-Feb-2016
ISSN: 0748-7983
Publisher: WB Saunders
Start Page: 813
End Page: 816
Journal / Book Title: European Journal of Surgical Oncology
Volume: 42
Issue: 6
Copyright Statement: © 2016, Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Keywords: AIDS
Anal cancer
Anal verge cancers
Local excision
Anal Canal
Anus Neoplasms
Follow-Up Studies
HIV Infections
Middle Aged
Minimally Invasive Surgical Procedures
Neoplasm Staging
Prospective Studies
Treatment Outcome
Anal cancer
Anal verge cancers
Local excision
Oncology & Carcinogenesis
1112 Oncology And Carcinogenesis
Publication Status: Published
Appears in Collections:Division of Surgery
Division of Cancer
Faculty of Medicine

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