Characteristics and oncological results of epidermoid anal carcinoma: Comparison analysis between immunocompetent and immunosuppressed patients

• Published in: Cirugia española (English ed.) 2022-11, Vol.100 (11), p.709-717
• Main Authors: Saralegui Ansorena, Yolanda, Enriquez-Navascues, Jose Maria, Placer Galan, Carlos, Borda Arrizabalaga, Nerea, Elosegui Aguirrezabala, Jose Luis, Elorza Echaniz, Garazi, Etxart Lopetegi, Ane, Aguirre Allende, Ignacio
• Format: Article
• Language: English
• Subjects: Anal squamous-cell carcinoma; Carcinoma escamoso anal; Disease-free survival; Immunocompetent; Immunocompromised; Inmunocompetente; Inmunodeprimido; Overall survival; Recidiva; Recurrence; Supervivencia global; Supervivencia libre de enfermedad
• ISSN: 2173-5077; 2173-5077
• DOI: 10.1016/j.cireng.2022.07.002

[Display omitted] Most evidence, including recent randomized controlled trials, analysing anal squamous cell carcinoma (SCC) do not consider immunocompromise patient population. The aim of this study was to compare clinical and oncological outcomes among immunocompetent and immunocompromised patients with anal squamous cell carcinoma. Multicentric retrospective comparative study including 2 cohorts of consecutive patients, immunocompetent and immunocompromised, diagnosed with anal SCC. This study evaluated clinical characteristics, clinical response to radical chemoradiotherapy (CRT) and long-term oncological results including both local and distant recurrence, overall survival (OS) and disease-free survival (DFS). A total of 84 patients, 47 (55.6%) female, diagnosed with anal SCC from January 2012 to December 2017 were included, 22 (26%) and 62 (74%) patients in immunocompromised and immunocompetent groups respectively. Patients in immunocompromised group were significantly younger (53 vs. 61 years; P = 0.001), with smaller tumoral size (P = 0.044) and reported higher rates of substance abuse including tobacco use (P = 0.034) and parenteral drug consumption (P = 0.001). No differences were found in administered therapies (P = 301) neither in clinical response to chemoradiotherapy (83 vs. 100%). Moreover, similar 5-year OS (60 vs. 64%; P = 0.756) and DFS (65 vs. 68%; P = 0.338) were observed. The present study shows no significant differences in long-term oncological results among immunocompetent and immunocompromised patients diagnosed with anal SCC, with a similar oncologic treatment. This evidence might be explained due to the close monitoring and adequate therapeutic control of HIV positive patients. La mayoría de los ensayos clínicos realizados sobre pacientes con cáncer escamoso anal (CEA) excluyen pacientes inmunodeprimidos. El objetivo del presente estudio es comparar las características y los resultados oncológicos entre pacientes con CEA inmunocomprometidos e inmunocompetentes. Estudio multicéntrico comparativo retrospectivo que incluye 2 cohortes consecutivas de pacientes, inmunocomprometidos e inmunocompetentes, diagnosticados de carcinoma escamoso anal. Se han investigado las características de los pacientes, los tratamientos realizados, la respuesta clínica al tratamiento con quimiorradioterapia (QRT), la recidiva local o a distancia, la supervivencia global (SG) y la supervivencia libre de enfermedad (SLE). De enero 2012 a diciembre 2017 hem