Anal Canal Carcinoma Research Articles

Prognostic impact of residual HPV ctDNA detection after chemoradiotherapy for anal canal carcinoma.

3565Background: Chemoradiotherapy (CRT) is the current standard of care for patients diagnosed with locally advanced anal squamous cell carcinoma (ASCC), but some patients will present a local and/...

Association of Interim FDG-PET Imaging During Chemoradiation for Squamous Anal Canal Carcinoma With Recurrence

Imaging parameters from 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) before and after chemoradiation therapy (CRT) for analcanal cancer correlate with clinical outcomes. This prospective, hypothesis-generating pilot study investigates the relationship between interim PET imaging during CRT for anal canal cancer and clinical outcome. From June 2012 to August 2015, 30 patients with anal canal cancer were enrolled in a prospective clinical study of PET prior to and during CRT after ∼30Gy. PET parameters of the primary site included maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG). MTV and TLG were calculated based on 40% SUVmax (MTV40, TLG40) orSUV 2.5 (MTV2.5, TLG2.5) thresholds for pretreatment and interim images. Absolute and change in PET parameters were assessed for association with freedom from local and regional recurrence (FFLR) using single-predictor Cox regression models. Local and regional recurrence were primary and nodal (in-field) recurrences, respectively. Twenty-three patients were eligible for analysis. Patients were excluded with nonsquamous cell histology, recurrent anal cancer, and incomplete studies due to treatment toxicity or patient choice. Median follow-up was 2.5years. Pretreatment MTV40 (HR 1.4 [95% CI 1.02-2.05]), interim MTV2.5 (1.4 [1.04-1.89]), and interim TLG2.5 (1.1 [1.01-1.21]) were associated with FFLR. In this prospective pilot study, interim PET parameters were associated with FFLR. These results warrant further investigation assessing the value of interim PET as a biomarker of response in the treatment of patients with anal cancer.

The prognostic role of hemoglobin levels in patients undergoing concurrent chemo-radiation for anal cancer

BackgroundConcurrent chemo-radiation (CT-RT) is a standard therapy for squamous cell carcinoma of anal canal. Different clinical and biological factors may potentially affect outcome. We investigated the prognostic role of baseline hemoglobin (Hb) in a cohort of anal cancer patients submitted to CT-RT with 5-fluorouracil and mitomycin C.MethodsUp to 161 patients with clinical stage T1-T4/N0-N3/M0 were treated. Response was assessed at 6 weeks and thereafter at 3, 6 and 12 months. Two different approaches were used:a)simultaneous integrated boost following RTOG 05-29 indications;b)first sequence of 45Gy/25 fractions to the pelvis followed by 9–14.4 Gy/5–8 fractions to the macroscopic disease. Primary endpoints were progression-free survival (PFS) and overall survival (OS).ResultsOn multivariate analysis, pre-treatment Hb level had a significant correlation to OS (HR:0.53;95% CI:0.33–0.87; p = 0.001), but not to PFS (HR:0.78;95% CI:0.53–1.15; p = 0.12) Patients with pre-treatment Hb ≥ 12 g/dl had 5-year PFS and OS of 82.2%, compared to 29.3% and 32.8% for those below the threshold. The likelihood to achieve a complete remission increased by 5.6% for every single-unit (g/dl) increase in baseline Hb level over 11 g/dl. On multivariate analysis, response to treatment had a significant correlation to PFS (incomplete vs complete response – HR:5.43;95% CI:2.75–10.7; p < 0.0001) and OS (HR: 6.96;95% CI:2.96–16.5; p < 0.0001).ConclusionsWe showed that baseline Hb level is a strong indicator for poor response to RT-CT in anal cancer patients. A close clinical monitoring for incomplete response to treatment should be advised in patients with low pre-treatment Hb. The hypothesis that the preservation of adequate Hb level during treatment may lead to a better outcome needs prospective evaluation.

EP-1471: Induction chemotherapy followed by chemoradiotherapy in locally advanced anal canal carcinoma

EP-1471: Induction chemotherapy followed by chemoradiotherapy in locally advanced anal canal carcinoma

High Prevalence of Anal Canal High-Risk Human Papillomavirus Infection in Patients With Crohn's Disease

The increasing incidence of anal canal carcinomas requires better knowledge on anal human papillomavirus (HPV) infection. We aimed to assess anal canal HPV infection prevalence and risk factors among patients seen at a gastroenterology department in France. We analyzed anal tissue samples collected from 469 consecutive patients (median age 54 years, 52% women), including 112 who received immunosuppressant therapies and 101 with inflammatory bowel disease (70 with Crohn's disease), who underwent colonoscopy examinations from April 1, 2012 to April 30, 2015. HPV was detected and genotyped using the INNO-LiPA assay, and we collected medical and demographic data from all subjects. Risk factors for any HPV, high-risk HPV (HR-HPV) and HPV16 infection were assessed by bivariate and multivariate analysis. The primary outcomes association of HR-HPV or HPV16 with medical and demographic features. We detected HPV DNA in anal tissues from 34% of the subjects and HR-HPV in 18%. HPV16 was the most prevalent genotype (detected in 7%), followed by HPV51, HPV52, and HPV39. HR-HPV was detected in a significantly higher proportion of samples from women (23.1%) than men (12.8%) (P = .0035); HR-HPV and HPV16 were detected in a significantly higher proportion of patients with Crohn's disease (30.0%) than without (18.1%) (P = .005). Female sex, history of sexually transmitted disease, lifetime and past year-number of sexual partners, active smoking, and immunosuppressive therapies were independent risk factors for anal HR-HPV infection in multivariate analysis. One third of patients who underwent colonoscopy at a gastroenterology department were found to have anal canal HPV infection. We detected HR-HPV infection in almost 20% of patients and in a significantly higher proportion of patients with Crohn's disease than without. Increasing our knowledge of HPV infection of anal tissues could help physicians identify populations at risk and promote prophylaxis with vaccination and adequate screening.

FDG-PET for Staging, Surveillance, and Prognostication in Anal Canal Carcinoma

Anal canal tumour burden holds prognostic information, but may be difficult to assess using computed tomography (CT). Position emission tomography (PET) can inform management, with suggestion that higher maximum standardized uptake value (SUVmax) and metabolic tumour volume (MTV) on pre-treatment PET predicts worse survival. We sought to prospectively assess the contributions of PET to initial staging, early detection of treatment failures, and prognostication in anal canal squamous cell carcinoma (ACC). Consecutive patients with biopsy-proven ACC referred for radical chemoradiotherapy (CRT) to a tertiary cancer centre consented to undergo 2-deoxy-2-[fluorine-18]fluoro-D-glucose (18F-FDG) PET/CT imaging pretreatment and at 3 and 6 months post-treatment. Clinicopathologic data were collected and CT and PET/CT imaging reviewed for contributions to staging and recurrence detection. SUVmax, peak standardized uptake value (SUVpeak), MTV, and total lesion glycolysis (TLG) were assessed for association with progression-free survival (PFS) and overall survival (OS) using a Cox proportional hazard model. Between May 2009 and January 2016, 60 patients with clinical stages I-IIIB ACC, 68% female, mean age 58 years, completed curative-intent radiotherapy and concurrent 5-fluorouracil and mitomycin C chemotherapy. Median follow-up was 38.5 months (range 6.0-83.7 mo). 17/60 (28.3%) experienced disease progression (10 local, 7 metastatic) with median time to progression 219 days. 10/60 (16.7%) died, with median time to death 1092 days. PET/CT vs. CT upstaged 22% of patients. Pre-treatment SUVmax, SUVpeak, MTV, and TLG did not significantly correlate with PFS or OS. 6-month post-treatment SUVmax and SUVpeak correlated with both OS and PFS (all HR 1.2, p≤0.005). 100% of treatment failures were detectable by the combination of clinical exam and PET/CT; however, when used in isolation, clinical exam, PET/CT, or CT failed to detect some recurrences. The 3- and 6-month post-treatment PET/CT in isolation detected 3 and 5 unique recurrences, respectively. Although pre-treatment PET/CT increased detection of nodal metastases, metabolic tumour characteristics did not predict survival outcomes in ACC following radical CRT. Post-treatment, the combination of clinical exam and PET/CT effectively detected all treatment failures; however the optimal timing of post-treatment PET/CT imaging remains unclear.

Anorectal function and quality of life after chemoradiotherapy in patients with anal canal carcinoma

Background: A retrospective study was conducted to evaluate sphincter function and quality of life (QoL) in patients treated with radiotherapy and concurrent chemotherapy (CRT) for anal canal cancer.&#x0D; Materials and Methods: From 1998 to 2010, patients with anal canal cancer treated with CRT were eligible. Radiation dose was 59.4 Gy (1.8 Gy/ fraction) and the chemotherapy regimen was 5-fluorouracil and mitomycin C. Anorectal function was investigated by anorectal manometry and transrectal ultrasound. QoL was assessed with the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C29 questionnaire. Correlations between diagnostic parameters and patient-reported outcomes were evaluated.&#x0D; Results: Eighteen patients were enrolled. Overall, 4 patients had stage I disease, 8 stage II and 6 stage III. Anorectal manometry parameters were significantly lower compared to healthy scores. Patients-reported continence was significantly higher than fecal incontinence manometry scores. Ultrasound sphincter complex defects were recorded in 17 patients. Globally, a positive correlation was described between resting pressure of manometric exam and sexual functioning items and sphincter complex and patient-reported flatulence, respectively.&#x0D; Conclusions: Definitive CRT represents the standard of care for anal canal cancer. Patients experienced low rates of fecal incontinence compared with results of diagnostic exams. Further studies are needed to better define toxicity and QoL after definitive CRT in anal canal cancer.

Primary Management of Squamous Cell Carcinoma of the Anal Canal: A 30-year Community Hospital Experience

ABSTRACTWe reviewed outcomes of 41 patients treated with curative-intent radiotherapy for anal canal carcinoma at a community hospital between 1985 and 2015. Twenty-six (63%) presented with stage I or II disease while 15 (37%) had stage III. Thirty-seven received definitive chemoradiation and 4 radiotherapy alone. Thirteen (31.7%) received ≤59.4Gy. Thirty-two (78%) were treated with 3-dimensional conformal radiotherapy while 9 (22%) received intensity-modulated radiotherapy. At 5 years, local control, regional control, freedom from distant metastasis, cause-specific survival, and overall survival were 80%, 98%, 88%, 77%, and 51%. Of those who received >59.4Gy, local control and overall survival were not improved.

SALVAGE SURGERY FOR ANAL CANAL CA. LONG TERM OUTCOMES FROM A TERTIARY REFERRAL CENTRE

Purpose: The purpose of this study was to analyse the outcome of salvage surgery in the management of anal canal cancer.Methodology: All patients with a diagnosis of anal canal carcinoma from 2006 to 2015 were studied. Basic demographic data were recorded. Treatment modalities used were recorded for all patients. Long-term surgical outcomes were recorded. Median survival in months was recorded. All data were recorded in the SPSS ver. 20.Results: A total of 62 patients were included in the study. Median age was 51. 38 patients had SCCa on histology and 24 had an adenocarcinoma. 52% of patients had a T4 lesion. Chemoradiotherapy (CRT) was offered to 59 (95%) patients as the first line of therapy. 12 (19%) patients had a complete response. 37 (60%) patients had a partial and 10 (16%) patients had no response to chemoradiation. Salvage surgery was offered to 27 patients. Of these, 21 had a curative resection. Six had irresectable disease and underwent a colostomy only. Median overall survival for all patients was 46 months with a 5-year survival of 55%. Patients with partial response who were offered salvage surgery the 5-year survival were 40%. For patients with no response or progressive disease after chemoradiation therapy, the 5-year survival was 20%.Conclusion: Long-term survival can be achieved in majority of patients who undergo radical salvage surgery after failed CRT for carcinoma of the anal canal.Key words: Adenocarcinoma, anal canal, chemoradiotherapy, surgery

Predictors of Nonadherence to NCCN Guideline Recommendations for the Management of Stage I Anal Canal Cancer

Background: Definitive chemoradiotherapy (CRT) is recommended by the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Anal Carcinoma for all patients with stage I anal canal cancer. Because these patients were not well represented in clinical trials establishing CRT as standard therapy, it is unclear whether NCCN recommendations are being closely followed for stage I disease. This study identified factors that predict for NCCN Guideline-concordant versus NCCN Guideline-discordant care. Methods: Using the National Cancer Data Base, we identified patients diagnosed with anal canal carcinoma from 2004 to 2012 who received concurrent CRT (radiotherapy [RT] 45.0-59.4 Gy with multiagent chemotherapy), RT alone (45.0-59.4 Gy), or surgical procedure alone (local tumor destruction, tumor excision, or abdominoperineal resection). Demographic and clinicopathologic factors were analyzed using the chi-square test and logistic regression modeling. Results: A total of 1,082 patients with histologically confirmed stage I anal cancer were identified, among whom 665 (61.5%) received CRT, 52 (4.8%) received RT alone, and 365 (33.7%) received only a surgical procedure. Primary analyses were restricted to patients receiving CRT or excision alone, as these were most common. Multivariable analysis identified factors independently associated with reduced odds of CRT receipt: low versus intermediate/high tumor grade (adjusted odds ratio [AOR], 0.21; 95% CI, 0.14-0.29; P<.001), tumor size <1 cm vs 1 to 2 cm (AOR, 0.24; 95% CI, 0.17-0.35; P<.001), age ≥70 versus 50 to 69 years (AOR, 0.36; 95% CI, 0.24-0.54; P<.001), male sex (AOR, 0.63; 95% CI, 0.45-0.90; P=.009), and treatment at an academic versus a non-academic facility (AOR, 0.58; 95% CI, 0.41-0.81; P=.002). Conclusions: Despite the NCCN recommendation of CRT for stage I anal cancer, at least one-third of patients appear to be receiving guideline-discordant management. Excision alone is more common for patients who are elderly, are male, have small or low-grade tumors, or were evaluated at academic facilities.

Proteomic signatures reveal a dualistic and clinically relevant classification of anal canal carcinoma.

Aetiologically linked to HPV infection, malignancies of the anal canal have substantially increased in incidence over the last 20 years. Although most anal squamous cell carcinomas (SCCs) respond well to chemoradiotherapy, about 30% of patients experience a poor outcome, for undetermined reasons. Despite cumulative efforts for discovering independent predictors of overall survival, both nodal status and tumour size are still the only reliable factors predicting patient outcome. Recent efforts have revealed that the biology of HPV-related lesions in the cervix is strongly linked to the originally infected cell population. To address the hypothesis that topography also influences both gene expression profile and behaviour of anal (pre)neoplastic lesions, we correlated both proteomic signatures and clinicopathological features of tumours arising from two distinct portions of the anal canal: the lower part (squamous zone) and the more proximal anal transitional zone. Although microdissected cancer cells appeared indistinguishable by morphology (squamous phenotype), unsupervised clustering analysis of the whole proteome significantly highlighted the heterogeneity that exists within anal canal tumours. More importantly, two region-specific subtypes of SCC were revealed. The expression profile (sensitivity/specificity) of several selected biomarkers (keratin filaments) further confirmed the subclassification of anal (pre)cancers based on their cellular origin. Less commonly detected compared to their counterparts located in the squamous mucosa, SCCs originating in the transitional zone more frequently displayed a poor or basaloid differentiation, and were significantly correlated with reduced disease-free and overall survivals. Taken together, we present direct evidence that anal canal SCC comprises two distinct entities with different cells of origin, proteomic signatures, and survival rates. This study forms the basis for a dualistic classification of anal carcinoma, with implications for management, outcome expectations, and possibly therapy. Copyright © 2016 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Savremeni terapijski pristup u lečenju karcinoma analnog kanala

Savremeni terapijski pristup u lečenju karcinoma analnog kanala

Interim FDG Positron Emission Tomography Imaging During Chemoradiation for Squamous Anal Canal Carcinoma

Interim FDG Positron Emission Tomography Imaging During Chemoradiation for Squamous Anal Canal Carcinoma

Prognostic factors of colostomy free survival in patients presenting with locally advanced anal canal carcinoma: A pooled analysis of two prospective trials (KANAL 2 and ACCORD 03)

Purpose The objective was to carry out a prognosis study of the prospective studies KANAL 2 and ACCORD 03 in order to highlight new prognostic factors of colostomy-free survival in patients with locally advanced anal canal carcinoma. Material and methods KANAL 2 and ACCORD 03 were phase 2 and phase 3 trials with same inclusion criteria. The patients recruited had cancer of the anal canal of ≥ 4 cm or N+ treated with concomitant radiochemotherapy (45 Gy/25 fractions) with 5FU and cisplatin. A univariate and multivariate analysis of different potential explanatory factors (patients, tumors, and treatments) were carried out through Cox regression modeling. Results Three hundred and ninety two patients were included. In multivariate analyses, the circumferential tumor spread (less than 1/3; between 1/3 and 2/3; more than 2/3) (HR = 2.06 and HR = 2.94, p = 0.003); the inguinal node involvement (HR = 1.64, p = 0.04) and the total radiotherapy dose below 60 Gy or above 65 Gy (HR = 1.97 and HR = 2.2, p = 0.006) were associated with a lower rate of colostomy-free survival. Age of over 55 years (HR = 0.64, p = 0.03) was associated with a higher rate of colostomy-free survival. Conclusion This prospective prognosis study demonstrates that, in patients with locally advanced anal cancer, the degree of circumferential tumor spread, the inguinal node involvement, and an overly low or high total radiotherapy dose are poor prognostic factors for colostomy-free survival. On the other hand, age of over 55 years is a positive prognostic factor.

Anal canal squamous carcinoma

BackgroundAnal canal carcinoma is a rare neoplasm, representing 2% of the digestive tumors, and the most common is squamous cell carcinoma, with an increasing incidence. ObjectiveThe study aims to elucidate the pathogenesis of an increasingly prevalent disease, as well as to update treatment and prognosis. MethodsA literature search in Pubmed database, including articles from 2005 to 2015 and cross-research articles with the initial research. ResultsSeveral studies prove the role of HPV as a major risk factor in the development of squamous cell carcinoma of anal canal, as well as a greater prevalence of this neoplasia in HIV-positive people and in those who practice receptive anal intercourse. In the last two decades chemoradiotherapy remains the treatment of choice, and abdominoperineal resection is reserved for those cases of treatment failure or recurrence. Evidence advances in order to adapt the treatment to each patient, taking into account individual prognostic factors and biological tumor characteristics. ConclusionsSquamous cell carcinoma of the anal canal is a neoplasm associated with HPV; therefore, screening and vaccination programs of male individuals, by way of prevention, should be started. Many studies are needed in order to achieve development in the treatment as well as in the evaluation of the biological characteristics of the tumor.

Atypical Granular Cell Tumor with Intranuclear Inclusions: A Case Report

Atypical and malignant granular cell tumors are relatively uncommon constituting 1-2% of all granular cell tumors. We present a case of 57 year old man known to have squamous cell carcinoma of anal canal in 2008, now presenting with a chest wall nodule of 2 months duration. Fine needle aspiration of the chest wall nodule yielded atypical pleomorphic cells with abundant granular cytoplasm and vesicular nuclei with prominent nucleoli and intranuclear inclusions. A biopsy was advised and tru cut biopsy proved it to be atypical granular cell tumor, positive forS100 and KP1. We present this case to increase the awareness of this uncommon entity presenting as a subcutaneous nodule.

Patient reported quality of life after helical IMRT based concurrent chemoradiation of locally advanced anal cancer

Background and purposeConcurrent chemoradiation (CCRT) is the standard treatment for locally advanced anal canal carcinoma, although treatment-related side effects can affect patient quality of life (QOL). The purpose was to prospectively evaluate the effects of Tomotherapy (HT) based CCRT on patient reported QOL in locally advanced anal cancer. Patients and MethodsFifty-four patients treated with HT and concurrent 5-fluorouracil/mitomycin-C underwent QOL evaluation at baseline, after treatment, and during follow-up with EORTC core (QLQ-C30) and colorectal (QLQ-CR29) questionnaires. The QOL scores at baseline and post-treatment were compared. ResultsAll C30 functional symptoms, except emotional and cognitive functioning, were impaired end-of-treatment and recovered by 3months follow-up. The majority of symptom scores were worse end-of-treatment but recovered by 3months except for fecal incontinence (FI), diarrhea, urinary incontinence (UI), and dyspareunia which persisted. FI returned to baseline at 12months while diarrhea, UI, and dyspareunia persisted. ConclusionsMost impaired functions and symptoms following HT based CCRT were temporary and improved by 3months post-therapy. Late complications affecting QOL were FI, sexual function, UI, and diarrhea. Our observations support routine use of IMRT and emphasize the significance of precise evaluation of sexual, urinary, and anorectal functions before starting CCRT and routine incorporation of QOL evaluations.

Anal Canal Carcinoma in a Child With Disorders of Sex Development.

Squamous cell carcinoma of the anal canal in children is rare. To date, the etiology and outcome of this condition have been not fully understood. Here, we report an 11-year-old child with anal canal cancer who had concomitant disorders of sex development. Radiotherapy followed by salvage surgery achieved disease-free survival of 3 years. Since overexpression of cell cycle regulatory protein p16 was immunohistochemically evident in tumor tissue, human papillomavirus infection was considered as a causative factor in the carcinogenesis.

Comparison of bone marrow sparing intensity modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3DCRT) in carcinoma of anal canal: a prospective study.

Chemoradiation (CRT) is the standard of care in anal canal carcinoma. CRT leads to suppression of iliac bone marrow (BM) leading to hematological toxicity. Intensity modulated radiation therapy (IMRT) technique can be used to decrease radiation dose to iliac BM and thus decrease haematological toxicity. This study aims to compare the haematological and gastrointestinal toxicity in BM sparing IMRT with three-dimensional conformal radiation therapy (3DCRT) in anal carcinoma patients. Twenty untreated, biopsy proven anal canal carcinoma (stages I-III) patients were randomized into IMRT and 3DCRT arm. All patients received CRT with 45 Gy in 25 fractions at 1.8 Gy/fraction and weekly concurrent inj. cisplatin and 5-FU. Patients were evaluated for acute haematological and gastrointestinal toxicity during treatment. Additional dosimetric comparison was made between the two groups. Incidence of worst hematological toxicity grade II (GII) and GIII was seen in 40% [4] vs. 30% [3] and 20% [2] vs. 0% [0] respectively, in 3DCRT and IMRT group. However these did not come as statistically significant (P=0.228). Incidence of worst gastrointestinal toxicity during treatment in terms of GII was 30% [3] vs. 50% [5] and GIII was 60% [6] vs. 0% [0] in 3DCRT and IMRT group respectively (P=0.010). Other parameters indicating better tolerance of treatment with IMRT arm than 3DCRT arm were lesser need for administration of parenteral fluid 10% [1] vs. 60% [6] (P=0.019); lesser need for blood transfusion 0% [0] vs. 20% [2] (P=0.060) in IMRT arm than in 3DCRT arm respectively. Patient requiring supportive care during treatment like need for anti-motility drugs and WHO. Step II analgesics also favored IMRT arm. Overall treatment time for Arm B (33.40 days) was less than what was seen in Arm A patients (36.8 days), although difference was not statistically significant (P=0.569). In terms of dosimetric analysis, arm B with the use of IMRT showed superiority over arm A with 3DCRT. The mean volume of bladder receiving ≥30 and 40 Gy respectively was 100% and 96% for group A (3DCRT) as compared to 68% and 31% for the group B (IMRT) (P<0.05). For bowel, although, the V30 and V40 for 3DCRT versus IMRT respectively were 51% and 27% vs. 27% and 13%, statistical significance was not reached (P>0.05). There was also less mean BM receiving ≥10 Gy (80.4%) and ≥20 Gy (65.6%) for group B using IMRT, than in 3DCRT (group A) were it was 91% and 73% respectively. Although for V10 it was significant (P=0.04), it did not reach statistical significance for the V20 (P=0.550). Preliminary outcomes suggest that BM sparing IMRT for anal canal cancers can decrease both haematological and gastrointestinal toxicity as compared to 3DCRT and thus CRT course can be completed effectively without treatment breaks.

PAPILLOMAVIRUS INFECTION: PRINCIPLE CHARACTERISTICS, CLINICAL MANIFESTATIONS, VACCINE PROPHYLAXIS

Papillomaviruses are a large and diverse group of viruses. It includes approximately 200 fully described types that have been detected in humans. Human papilloma viruses (HPV) are etiologic agents during various, benign and malignant lesions of mucous membrane and skin epithelium. Very importantly, persistent HPV infection of certain types is a leading cause of carcinoma of uterine cervix, penis, vulva; vagina, anal canal and fauces (including tongue base and tonsils). HPV infection prophylaxis is the best means to control HPV-conditioned diseases, and vaccination, as had been demonstrated, --the most effective method of its prophylaxis. In this paper principle characteristics and clinical manifestations of papillomavirus infection, as well as effectiveness of vaccination against HPV are examined.