Lower GI 2016

Is the prognosis of Anal cancer worse in HIV infected patients ?

Oehler – Janne et al ( 2008 )

•

• 40 consecutive HIV(+) patients from 4 centres in Switzerland, France & Canada treated with CRT between 1997-2006

Compared with 81 HIV(-) patients

•

98 % SCC

•

poorer local control experienced by HIV(+) group with significantly higher colostomy rate Higher treatment related toxicity Less use of MMC in HIV(+) group Longer duration of RT in HIV(+) group ( ? more treatment breaks)

HIV (+) HIV (-)

cCR

92% 96%

5 yr local control

38% 87%*

5 yr sphincter preservation 38% 74%**

5 yr DM free survival

91% 84%

5 yr DSS

68% 85%***

5 yr OS

61% 65%

Acute G3/4 toxicity

48% 31%

Severe skin toxicity

35% 17%

Severe haematologic toxicity 33% 12%

( * P = 0.008 ; **p = 0.035 ; *** p = 0.09 )