Extensive anal condylomatosis: prognosis in relation to viral and host factors

Objective  To evaluate the clinical course of extensive anal condylomatosis in relation to treatment modalities, patient comorbidity and immune function, and associated papillomavirus (HPV) sequences. Method  Clinical data, treatment modalities and follow‐up were recorded and analysed in relation to...

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Bibliographic Details
Published in:Colorectal disease 2010-07, Vol.12 (7Olie), p.e128-e134
Main Authors: Sarzo, G., Mistro, A., Finco, C., Frayle-Salamanca, H., Marino, F., Franzetti, M., Ferrara, R., Mistrangelo, M., Savastano, S., Vecchiato, M., Merigliano, S.
Format: Article
Language:English
Subjects:
Adult
Aged
Anal condylomatosis
Busckhe-Lowenstein Tumor
Colectomy - methods
Condylomata Acuminata - diagnosis
Condylomata Acuminata - surgery
Condylomata Acuminata - virology
Diagnosis, Differential
DNA, Viral - analysis
Female
Follow-Up Studies
Hepatitis Viruses - genetics
HIV - genetics
HPV type
Humans
Male
Middle Aged
Proctitis - diagnosis
Proctitis - surgery
Proctitis - virology
Prognosis
Retrospective Studies
Young Adult
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Summary:Objective  To evaluate the clinical course of extensive anal condylomatosis in relation to treatment modalities, patient comorbidity and immune function, and associated papillomavirus (HPV) sequences. Method  Clinical data, treatment modalities and follow‐up were recorded and analysed in relation to host and viral type. Histology, immunohistochemistry and molecular analyses for HPV search and typing were performed on formalin‐fixed paraffin‐embedded samples. Results  Sixteen patients [14 males, median age 41.8 years (range 19–66)] affected by extensive anal condylomatosis [10 Buschke‐Lowenstein Tumors (BLT) and 6 condylomatosis] treated in three different Italian institutions were included. There was associated preoperative anal intraepithelial neoplasia grade 3 (AIN3) in one and invasive carcinoma in three patients. After radical resection (n = 16) recurrence occurred in 4/10 (40%) BLT patients. Malignancy before or after treatment developed in 5/16 (31.25%) patients. HPV sequences were present in all the samples of 15 evaluable patients (types 6 or 11, 9 patients; type 16, 6 patients). A statistically significant association was found between presence of HPV type 16 and both malignancy and recurrence. Viral variant L83V was present in 3/4 HPV 16 positive recurrent cases. Conclusion  Radical resection resulted in a favourable clinical course. Typing of HPV sequences in the management of patients affected by extensive anal condylomatosis may be useful.
ISSN:1462-8910
1463-1318
DOI:10.1111/j.1463-1318.2009.01902.x