{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:08:24Z","timestamp":1790665704673,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,9,25]],"date-time":"2017-09-25T00:00:00Z","timestamp":1506297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,9,25]],"date-time":"2017-09-25T00:00:00Z","timestamp":1506297600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The incidence of squamous cell carcinoma (SCC) of the anal canal has been rising over the past decades, especially in patients infected with human immunodeficiency virus (HIV). Despite the advent of potent multidrug regimens to treat HIV\u2010termed highly active antiretroviral therapy (HAART), anal SCC rates have not declined, and the impact of HAART on anal SCC remains controversial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The purpose of this study was to define outcomes of anal SCC treatment in HIV\u2010positive and HIV\u2010negative patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and materials<\/jats:title><jats:p>A retrospective single\u2010institution analysis was performed on all patients with anal SCC treated at the Johns Hopkins Hospital between 1991 and 2010. The primary outcomes measured were 5\u2010year overall survival (5\u2010year OS), median survival, and relapse rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our search identified 93 patients with anal SCC. Patients had a mean age of 54 years; 37.6% were male, and 21.5% were HIV\u2010positive. Median follow\u2010up was 28\u00a0months. Relapse occurred in 16.1% of patients. Median time to relapse was 20\u00a0months. Relapse rates were slightly higher with HIV\u2010positive versus negative patients (30.0 vs. 12.3%) but did not reach statistical significance (<jats:italic>p<\/jats:italic> = 0.06). Among HIV\u2010positive patients, those who relapsed were more likely to be on HAART than those who did not relapse (83.3 vs. 14.3%, <jats:italic>p<\/jats:italic> = 0.007). 5\u2010year OS was 58.9% for the total group of patients with no significant difference between those who relapsed versus those who did not (76.2 vs. 54.5%, <jats:italic>p<\/jats:italic> = 0.20). No survival difference was seen between HIV\u2010positive and negative patients. Survival was associated with AJCC stage in all patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In our small series, HIV infection was not associated with a significantly higher relapse rate or worse 5\u2010year OS among patients with anal SCC. HAART was associated with a higher rate of relapse in HIV\u2010positive patients. AJCC staging predicted survival in both relapsed and non\u2010relapsed patients regardless of HIV status.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-017-4201-6","type":"journal-article","created":{"date-parts":[[2017,9,25]],"date-time":"2017-09-25T15:45:03Z","timestamp":1506354303000},"page":"876-883","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Prognostic and Predictive Clinicopathologic Factors of Squamous Anal Canal Cancer in HIV\u2010Positive and HIV\u2010Negative Patients: Does HAART Influence Outcomes?"],"prefix":"10.1002","volume":"42","author":[{"given":"Emmanouil P.","family":"Pappou","sequence":"first","affiliation":[{"name":"Division of Colon and Rectal Surgery, Interim Director, Department of Surgery The Johns Hopkins Hospital 720 Rutland Avenue \u2010 Ross 759 21205 Baltimore MD USA"},{"name":"Department of Colorectal Surgery Memorial Sloan Kettering Cancer Center New York NY 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M.","family":"Herman","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Johns Hopkins Medical Institutions Baltimore MD USA"},{"name":"Department of Radiation Oncology MD Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandy","family":"Fang","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery, Interim Director, Department of Surgery The Johns Hopkins Hospital 720 Rutland Avenue \u2010 Ross 759 21205 Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth C.","family":"Wick","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery, Interim Director, Department of Surgery The Johns Hopkins Hospital 720 Rutland Avenue \u2010 Ross 759 21205 Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bashar","family":"Safar","sequence":"additional","affiliation":[{"name":"Division of Colon 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