Icahn School of Medicine at Mount Sinai, New York, New York.
Stanford University School of Medicine, Palo Alto, California.
AIDS. 2019 Jul 1;33(8):1353-1360. doi: 10.1097/QAD.0000000000002200.
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 lung cancers, but its safety is unclear in the setting of HIV. From a national cohort, we assessed potential differences in the risk of major lung cancer surgery complications by HIV status.
We linked clinical and cancer data from the Veterans Aging Cohort Study (VACS) and Veterans Affairs Corporate Data Warehouse to outcomes from the Veterans Affairs Surgical Quality Improvement Program (VASQIP) and identified 8371 patients (137 PWH, 8234 uninfected) who underwent lung cancer surgeries between 2000 and 2016.
We compared rates of 15 major short-term surgical complications by HIV status.
Use of surgical resection for early-stage lung cancer did not differ by HIV status. Lung cancer surgery postoperative (30-day) mortality was 2.0% for PWH and did not differ by HIV status (P = 0.9). Pneumonia was the most common complication for both PWH and uninfected veterans, but did not differ significantly in prevalence between groups (11.0% for PWH versus 9.4%; P = 0.5). The frequency of complications did not differ by HIV status for any complication (all P > 0.3). There were no significant predictors of postoperative complications for PWH.
In a national antiretroviral-era cohort of lung cancer patients undergoing surgical lung resection, short-term outcomes after surgery did not differ significantly by HIV status. Concerns regarding short-term surgical complications should have limited influence on treatment decisions for PWH with lung cancer.
肺癌是艾滋病毒（HIV）感染者（PWH）癌症死亡的主要原因。手术切除是早期肺癌潜在治愈治疗方案的关键组成部分，但在 HIV 环境下，其安全性尚不清楚。本研究从全国队列中评估了 HIV 状态对主要肺癌手术并发症风险的潜在差异。
我们将退伍军人老龄化队列研究（VACS）和退伍军人事务公司数据仓库中的临床和癌症数据与退伍军人事务部手术质量改进计划（VASQIP）的结果相关联，并确定了 8371 名（137 名 PWH，8234 名未感染者）在 2000 年至 2016 年间接受肺癌手术的患者。
我们比较了 HIV 状态与 15 种主要短期手术并发症的发生率。
早期肺癌的手术切除使用率与 HIV 状态无关。PWH 肺癌手术后（30 天）死亡率为 2.0%，与 HIV 状态无关（P=0.9）。肺炎是 PWH 和未感染者的最常见并发症，但两组之间的患病率没有显著差异（PWH 为 11.0%，未感染者为 9.4%；P=0.5）。任何并发症的发生率在两组之间均无显著差异（所有 P＞0.3）。PWH 术后并发症无明显预测因素。
在一个全国性的抗逆转录病毒时代的肺癌患者手术切除队列中，手术后的短期结果与 HIV 状态无显著差异。对于患有肺癌的 PWH，短期手术并发症不应成为治疗决策的主要考虑因素。
