Squamous-cell carcinoma of the head and neck in patients with HIV infection

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Although there is a paucity of published information on HIVpositive patients with squamous-cell carcinoma of the head and neck, the association between this cancer and HIV infection is well-recognized. The medical records of 1 9 patients with HIV infection and head and neck cancer who were treated between January 1 990 and June 1 996 were obtained through our tumor registry. All patients had positive results on serologic testing for HIV and had a histopathologic diagnosis of squamous-cell carcinoma of the head and neck. Forty-two percent of patients were younger than 50 years of age. Approximately 90% had a history of exposure to tobacco or alcohol. Thirteen patients (68%) fulfilled the 1993 revised criteria for AIDS from the Centers for Disease Control and Prevention. Six other patients were HIV-positive without signs or symptoms of AIDS. The most common site of involvement was the oropharynx (42%). The patients' AIDS status was associated with advanced stage of squamous-cell carcinoma and poor survival (P= 0.01). Median survival for the entire group was 10.3 months. Of the six HIV-positive patients without AIDS, four had stage l/ll cancer. Four of the six were alive with no evidence of disease at a mean follow-up of 1 7 months. Results suggested that squamous-cell carcinoma of the upper aerodigestive tract may develop at a younger age in patients with HIV infection. Long-term survival of squamouscell carcinoma is most likely to occur in asymptomatic HIVpositive patients with CD4 cell counts greater than 200 u/L.

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