Upper aerodigestive tract squamous cell carcinoma: The human immunodeficiency virus connection Journal Article


Authors: Singh, B.; Balwally, A. N.; Shaha, A. R.; Rosenfeld, R. M.; Har-El, G.; Lucente, F. E.
Article Title: Upper aerodigestive tract squamous cell carcinoma: The human immunodeficiency virus connection
Abstract: Objective: To evaluate the incidence, distribution, and course of squamous cell carcinoma (SCC) of the upper aerodigestive tract in patients infected with the human immunodeficiency virus (HIV) and compare it to SCC in non- HIV-infected patients. Design: Case-control study of all patients with SCC during a 9.5-year period from January 1985 through June 1994. Setting: Two academic tertiary care centers in a metropolitan location. Participants: Five hundred thirty-nine patients (18 to 95 years old) with SCC of the upper aerodigestive tract. Results: Infection with HIV was present in 4.5% of the patients with SCC of the upper aerodigestive tract. Patients infected with HIV were significantly younger than noninfected patients (P≤ <.001), accounting for 21.3% of those patients younger than 45 years (P<.001). No significant difference in tumor location was present between HIV-infected and noninfected patients; however, HIV-infected patients had larger tumors (P=.004) and a more advanced tumor stage (TNM classification) at presentation (P=.05). Tumor-related survival was significantly poorer in patients with HIV infection (P=.01), with 57% at 1 year and 32% at 2 years, compared with 74% and 59%, for non-HIV-infected patients. The detrimental effect of HIV infection on survival remained significant after adjusting for the confounding effects of age, tumor stage, and location of the tumor. All study patients with HIV infection had cancer risk factors such as tobacco and/or alcohol abuse. Conclusions: Infection with HIV possibly accelerates the development of SCC in patients with significant risk factors, presumably by impairing normal immune surveillance mechanisms. The decreased survival rates among these patients suggests that the SCC may be more aggressive or that other cofactors assume greater importance. A history of tobacco and/or alcohol abuse in patients with HIV infection warrants aggressive screening and early detection, to allow for early detection, which may help increase survival.
Keywords: adolescent; adult; cancer survival; controlled study; aged; aged, 80 and over; middle aged; major clinical study; case-control studies; clinical trial; squamous cell carcinoma; carcinoma, squamous cell; laryngeal neoplasms; cancer risk; cancer staging; human immunodeficiency virus infection; follow-up studies; cancer diagnosis; tumor localization; controlled clinical trial; cancer screening; smoking; age factors; risk factor; time factors; carcinogenesis; digestive system cancer; data interpretation, statistical; acquired immune deficiency syndrome; tobacco; nasopharyngeal neoplasms; mouth neoplasms; parotid neoplasms; hiv infections; oropharyngeal neoplasms; hypopharyngeal neoplasms; pharyngeal neoplasms; alcohol abuse; humans; prognosis; human; male; female; article
Journal Title: Archives of Otolaryngology - Head & Neck Surgery
Volume: 122
Issue: 6
ISSN: 0886-4470
Publisher: American Medical Association  
Date Published: 1996-06-01
Start Page: 639
End Page: 643
Language: English
PUBMED: 8639296
PROVIDER: scopus
DOI: 10.1001/archotol.1996.01890180047012
DOI/URL:
Notes: Correction issued, see DOI: 10.1001/archotol.1996.01890210024006 -- Article -- Export Date: 22 November 2017 -- Source: Scopus
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  1. Ashok R Shaha
    700 Shaha