Short-term outcomes for lung cancer resection surgery in HIV infection

Sigel, Keith; Stone, Kimberly; Wisnivesky, Juan P.; Park, Lesley S.; Kong, Chung Yin; Silverberg, Michael J.; Brown, Sheldon T.; Goetz, Matthew Bidwell; Rodriguez‐Barradas, Maria C.; Gibert, Cynthia L.; Shebl, Fatma M.; Bedimo, Roger; Wadia, Roxanne; King, Joseph T.; Crothers, Kristina

doi:10.1097/qad.0000000000002200

Cited by 10 publications

(5 citation statements)

References 25 publications

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“…Data on the prognosis following surgery in PLWH with malignancy are limited. In a national cohort, short-term outcomes after surgical lung resection did not differ significantly between lung cancer patients with and without HIV well managed with ART medication [ 26 ]. Another study reported that HIV status did not adversely affect outcomes in African patients with head and neck cancer [ 27 ], but this conclusion was limited by the suboptimal medical treatment received by all participants in local areas.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome of renal cell carcinoma in patients with HIV who undergo surgery

Chen

Zheng

et al. 2022

BMC Infect Dis

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Background People living with HIV (PLWH) have a higher risk for cancer compared to the general population. The prevalence of renal cell carcinoma (RCC) in PLWH has gradually increased in recent years, but relevant data on outcomes after surgery are scarce. We thus evaluated long-term outcomes after surgery in RCC patients with and without HIV. Methods This retrospective study included 67 patients with RCC, both HIV positive or negative, who underwent surgical treatment in our hospital between January 2012 and January 2021. Demographic details, clinical data, and cancer status were collected. We set the day of surgery as the baseline. The co-primary end points in this time-to-event analysis were overall survival and progression-free survival. We used a multivariate Cox model to compare the prognosis of PLWH and HIV-negative patients and present Kaplan–Meier curves for the co-primary end points. Results Of 261 consecutive patients, 18 patients who forwent treatment before surgery, 133 cases with incomplete data, 16 patients classified as clinical stage IV, 11 PLWH patients did not received antiretroviral therapy and 16 patients with metastasis were excluded from the main analysis. Of the remaining 67 patients, 33 individuals had HIV and the other 34 did not. The median overall survival was 74.9 months (95% confidence interval [CI] = 64.6 to 85.2) in PLWH and 96.4 months (95% CI = 90.0 to 102.9) in the HIV-negative group. Progression-free survival was 66.4 months (95% CI = 53.5 to 79.3) and 90.6 months (95% CI = 81.1 to 100.1), respectively. RCC patients with HIV who underwent surgery had a shorter survival time (hazard ratio [HR] = 2.8, 95% CI = 1.1 to 7.0, p = 0.016) and an increased incidence of tumor progression (HR = 2.7, 95% CI = 1.1 to 6.8, p = 0.028). Univariate and multivariate Cox regression analyses showed that a lower ratio of CD4+ T cells to CD8+ T cells (adjusted odds ratio = 0.092, 95% CI = 0.01 to 0.70, p = 0.022) was associated with worse survival among PLWH. Conclusion In this retrospective analysis of RCC patients who underwent surgery, PLWH had worse overall survival and shorter progression-free survival compared to HIV-negative cases.

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Section: Discussionmentioning

confidence: 99%

Long-term outcome of renal cell carcinoma in patients with HIV who undergo surgery

Chen

Zheng

et al. 2022

BMC Infect Dis

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“…Several studies investigating perioperative outcomes in patients undergoing colorectal, cardiac, and thoracic surgery in the United States demonstrated no differences in mortality. 30–32 However, other studies demonstrated an increased risk of perioperative and 1-year mortality among patients with HIV, with CD4 count, HIV viral loads, and hypoalbuminemia as risk factors for complications. 15,33 Lin et al investigated the outcomes of open abdominal aortic surgery in 48 patients with HIV with aneurysms or aortoiliac occlusive disease.…”

Section: Discussionmentioning

confidence: 99%

Trends and perioperative outcomes of patients with human immunodeficiency virus (HIV) undergoing lower extremity revascularization

et al. 2020

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The development of highly active antiretroviral therapy (HAART) has significantly improved the life expectancy of patients with human immunodeficiency virus (HIV), but has led to the rise of chronic conditions including peripheral artery disease (PAD). However, trends and outcomes among patients with HIV undergoing lower extremity revascularization are poorly characterized. The aim of this study was to investigate the trends and perioperative outcomes of lower extremity revascularization among patients with HIV and PAD in a national database. The National Inpatient Sample (NIS) was reviewed between 2003 and 2014. All hospital admissions with a diagnosis of PAD undergoing lower extremity revascularization were stratified based on HIV status. Outcomes were assessed using propensity score matching and multivariable regression. Among all patients undergoing lower extremity revascularization for PAD, there was a significant increase in the proportion of patients with HIV from 0.21% in 2003 to 0.52% in 2014 ( p < 0.01). Patients with HIV were more likely to be younger, male, and have fewer comorbidities, including coronary artery disease and diabetes, at the time of intervention compared to patients without HIV. With propensity score matching and multivariable regression, HIV status was associated with increased total hospital costs, but not length of stay, major amputation, or mortality. Patients with HIV with PAD who undergo revascularization are younger with fewer comorbidities, but have increased hospital costs compared to those without HIV. Lower extremity revascularization for PAD is safe for patients with HIV without increased risk of in-hospital major amputation or mortality, and continues to increase each year.

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“…Moreover, a recent data collection about a national cohort of LC patients showed that surgery is safe in HIV-positive patients (n = 137), being surgical complications and 30-day mortality similar to those uninfected ones (n = 8234) [47]. Small single institution series of NSCLC patients (n = 6) who underwent lobectomy or segmentectomy seems to confirm the feasibility of surgery in HIV-positive patients [48].…”

Section: Surgery and Radiotherapymentioning

confidence: 91%

Lung Cancer (LC) in HIV Positive Patients: Pathogenic Features and Implications for Treatment

Frega

Ferro

Bonanno

et al. 2020

IJMS

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The human immunodeficiency virus (HIV) infection continues to be a social and public health problem. Thanks to more and more effective antiretroviral therapy (ART), nowadays HIV-positive patients live longer, thus increasing their probability to acquire other diseases, malignancies primarily. Senescence along with immune-system impairment, HIV-related habits and other oncogenic virus co-infections increase the cancer risk of people living with HIV (PLWH); in the next future non-AIDS-defining cancers will prevail, lung cancer (LC) in particular. Tumor in PLWH might own peculiar predictive and/or prognostic features, and antineoplastic agents’ activity might be subverted by drug-drug interactions (DDIs) due to concurrent ART. Moreover, PLWH immune properties and comorbidities might influence both the response and tolerability of oncologic treatments. The therapeutic algorithm of LC, rapidly and continuously changed in the last years, should be fitted in the context of a special patient population like PLWH. This is quite challenging, also because HIV-positive patients have been often excluded from participation to clinical trials, so that levels of evidence about systemic treatments are lower than evidence in HIV-uninfected individuals. With this review, we depicted the epidemiology, pathogenesis, clinical-pathological characteristics and implications for LC care in PLWH, offering a valid focus about this topic to clinicians.

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Short-term outcomes for lung cancer resection surgery in HIV infection

Abstract: Objective: Lung cancer is the leading cause of cancer death in people living with HIV (PWH). Surgical resection is a key component of potentially curative treatment regimens for early stage

Cited by 10 publications

References 25 publications

Long-term outcome of renal cell carcinoma in patients with HIV who undergo surgery

Long-term outcome of renal cell carcinoma in patients with HIV who undergo surgery

Trends and perioperative outcomes of patients with human immunodeficiency virus (HIV) undergoing lower extremity revascularization

Lung Cancer (LC) in HIV Positive Patients: Pathogenic Features and Implications for Treatment

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