Incidence of head and neck malignancies and long-term survival in patients with HIV infection

Introduction:

Patients with HIV infection (HIV) have an increased risk of neoplasia caused by immunosuppression and frequent simultaneous infection with HPV viruses. In Germany, the prevalence of HIV infection is 1‰. The aim of the study was to investigate the incidence of head and neck cancer in HIV patients as well as prognosis and treatment options.

Methods:

Evaluation of clinical and pathological data of patients with head and neck cancer who have an HIV infection and identification of prognostic factors.

Results:

Fifty of 4894 patients with head and neck cancer (1.02%) treated in the Charité Universitätsmedizin between 2009 – 17 have HIV infection. Localization: 14 oral cavity, 16 oropharynx, 9 hypopharynx, 4 laryngeal, 4 paranasal sinuses, 2 nasopharynx, 1 salivary gland. Histology: 48 squamous cell carcinoma, 1 acinar cell carcinoma, 1 angiosarcoma. 24 patients were treated surgically, 7 with adjuvant chemo(radio) therapy (C(R)T). 19 patients primary CRT, 2 patients only CT, 1 patient only palliative radiotherapy. After a median follow-up of 3.7 years after initial diagnosis, median survival was 40 months and 1, 3, and 5 years survival was 40%, 14%, and 10%, respectively. In univariate analysis, T-stage (P = 0.009) and tumor localization (P = 0.013) were significant. The results of operation vs. CRT were 33 vs. 15 months median survival (P =.023) significantly better.

Conclusion:

Patients with head and neck cancer have a 10-fold increased risk of HIV. The prognosis for HIV-positive patients with head and neck cancer is inferior compared to non-infected individuals (1, 3, and 5-year survival rates 85%, 52% and 43%, Munich Cancer Registry). Early diagnosis and surgical therapy are prognostically crucial.

Publication History

Publication Date:
23 April 2019 (online)