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dc.contributor.authorBrogden, DRL
dc.contributor.authorKontovounisios, C
dc.contributor.authorChong, I
dc.contributor.authorTait, D
dc.contributor.authorWarren, OJ
dc.contributor.authorBower, M
dc.contributor.authorTekkis, P
dc.contributor.authorMills, SC
dc.date.accessioned2021-09-07T08:35:17Z
dc.date.available2021-09-07T08:35:17Z
dc.identifier.citationTechniques in coloproctology, 2021, 25 (9), pp. 1027 - 1036
dc.identifier.issn1123-6337
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/4796
dc.identifier.eissn1128-045X
dc.identifier.doi10.1007/s10151-021-02473-0
dc.description.abstractBackground Anal squamous cell carcinoma (ASCC) is an uncommon cancer associated with human immunodeficiency virus (HIV) infection. There has been increasing interest in providing organ-sparing treatment in small node-negative ASCC's, however, there is a paucity of evidence about the use of local excision alone in people living with HIV (PLWH). The aim of this study was to evaluate the efficacy of local excision alone in this patient population.Methods We present a case series of stage 1 and stage 2 ASCC in PLWH and HIV negative patients. Data were extracted from a 20-year retrospective cohort study analysing the treatment and outcomes of patients with primary ASCC in a cohort with a high prevalence of HIV.Results Ninety-four patients were included in the analysis. Fifty-seven (61%) were PLWH. Thirty-five (37%) patients received local excision alone as treatment for ASCC, they were more likely to be younger (p = 0.037, ANOVA) and have either foci of malignancy or well-differentiated tumours on histology (p = 0.002, Fisher's exact test). There was no statistically significant difference in 5-year disease-free survival and recurrence between treatment groups, however, patients who had local excision alone and PLWH were both more likely to recur later compared to patients who received other treatments for ASCC. (72.3 months vs 27.3 months, p = 0.06, ANOVA, and 72.3 months vs 31.8 months, p = 0.035, ANOVA, respectively).Conclusions We recommend that local excision be considered the sole treatment for stage 1 node-negative tumours that have clear margins and advantageous histology regardless of HIV status. However, PLWH who have local excision alone must have access to an expert long-term surveillance programme after treatment to identify late recurrences.
dc.formatPrint-Electronic
dc.format.extent1027 - 1036
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectHumans
dc.subjectHIV Infections
dc.subjectCarcinoma, Squamous Cell
dc.subjectAnus Neoplasms
dc.subjectNeoplasm Recurrence, Local
dc.subjectRetrospective Studies
dc.titleLocal excision and treatment of early node-negative anal squamous cell carcinomas in a highly HIV prevalent population.
dc.typeJournal Article
dcterms.dateAccepted2021-05-30
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1007/s10151-021-02473-0
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfTechniques in coloproctology
pubs.issue9
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Ashworth Collaborators
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Ashworth Collaborators
pubs.publication-statusAccepted
pubs.volume25
pubs.embargo.termsNot known
icr.researchteamAshworth Collaborators
icr.researchteamAshworth Collaboratorsen_US
dc.contributor.icrauthorChong, Yu-Shingen


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