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Recurrence After Treatment of Cutaneous Basal Cell and Squamous Cell Carcinomas in Patients Infected With Human Immunodeficiency Virus

2013; American Medical Association; Volume: 149; Issue: 2 Linguagem: Inglês

10.1001/2013.jamadermatol.245

2168-6084

Amelia K. Hausauer, Toby Maurer, Kieron Leslie, Rupa Parvataneni, Sarah Stuart, Mary‐Margaret Chren,

Cancer and Skin Lesions

Cutaneous basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), collectively called nonmelanoma skin cancer (NMSC), are the most common primary malignant neoplasms, yet recurrence after treatment is unusual. 1 With modern antiretroviral therapy, NMSC is also the most frequent cancer in persons infected with human immunodeficiency virus (HIV), 2 but recurrence rates in this population are largely unknown. 3We followed a large prospective cohort of patients with NMSC to determine tumor recurrence rates and found unexpectedly high recurrence among the HIV-infected patients. MethodsThis study was approved by the committee on human research, University of California, San Francisco, and details of this study have been described elsewhere. 1Briefly, eligible patients were those with primary NMSC diagnosed in 1999 or 2000 at a university-based practice and its affiliated Veterans Affairs Medical Center.Data were collected via medical records, patient survey, and blinded physical examination, and patients were followed up for a median (interquartile range [IQR]) of 7.3 (3.1-8.7) years after treatment.Given the prevalence of human papilloma virus-associated genital SCCs among HIV-infected patients, tumors located in the genital area were excluded from all analyses.We compared groups by the χ 2 test for categorical characteristics and Wilcoxon rank sum test for continuous characteristics.Cumulative incidence of tumor recurrence over time was displayed using Kaplan-Meier plots.We also constructed a series of Cox proportional hazard models to calculate unadjusted and adjusted 5-year recurrence rates and hazard ratios (HRs).Because of the limited number of recurrences, we forced HIV status and treatment type (categorized as conservative [destruction, topical, or none] or aggressive [excisional or Mohs surgery]) into the adjusted models then applied a forward stepwise selection based on ©2013 American Medical Association.