Department of Thoracic Surgery, Shanghai Public Health Clinical Center, Shanghai, China.
Department of Pharmacy, Shanghai Public Health Clinical Center, Shanghai, China.
Thorac Cancer. 2020 Aug;11(8):2146-2154. doi: 10.1111/1759-7714.13519. Epub 2020 Jul 5.
The purpose of this study was to investigate the risk factors of postoperative complications and reliable prognostic factors of long-term survival in HIV-infected patients with non-small cell lung cancer (NSCLC).
HIV-infected patients with NSCLC who underwent surgical treatment were retrospectively studied; a single-institutional analysis was conducted from November 2011 to August 2018. Pre- and postoperative clinical data, including age, gender, smoking history, highly active antiretroviral therapy (HAART), CD4+ T cell count, HIV viral load, cancer histology, clinical and pathological stage (p-stage), surgical result, Glasgow Prognostic Score (GPS), the Charlson comorbidity index (CCI), survival time and postoperative complications were collected.
A total of 33 HIV-infected patients with NSCLC were enrolled of which 18 (54.7%) had preoperative comorbidities and postoperative complications were observed in 22 (66.7%) patients. Thirty-day mortality was not observed in these patients. Median survival time after surgery was 65 months: the MST of p-stage I patients was 65 months; p-stage II MST was unestimable; p-stage III MST was 21 months. Univariate analyses showed that postoperative complications were associated with HIV viral load (P = 0.002), CCI (P = 0.027), HAART (P = 0.028) and CD4+ T cell count (P = 0.045). However, multiple logistic regression analysis showed no correlation between HAART and postoperative complications. The p-stage was an independent prognostic factor for survival time.
In our single-arm retrospective analysis, the risk factors for postoperative complications in HIV-infected patients with NSCLC were HIV viral load, CCI and CD4+ T cell counts. The p-stage was a predictive factor for long-term survival.
本研究旨在探讨 HIV 感染的非小细胞肺癌（NSCLC）患者术后并发症的危险因素和长期生存的可靠预后因素。
回顾性研究了 2011 年 11 月至 2018 年 8 月期间接受手术治疗的 HIV 感染的 NSCLC 患者；进行了单机构分析。收集了术前和术后的临床数据，包括年龄、性别、吸烟史、高效抗逆转录病毒治疗（HAART）、CD4+T 细胞计数、HIV 病毒载量、癌症组织学、临床和病理分期（p 分期）、手术结果、格拉斯哥预后评分（GPS）、Charlson 合并症指数（CCI）、生存时间和术后并发症。
共纳入 33 例 HIV 感染的 NSCLC 患者，其中 18 例（54.7%）术前合并症，22 例（66.7%）患者术后出现并发症。这些患者没有 30 天死亡率。手术后中位生存时间为 65 个月：p 分期 I 患者的 MST 为 65 个月；p 分期 II 的 MST 不可估计；p 分期 III 的 MST 为 21 个月。单因素分析显示，术后并发症与 HIV 病毒载量（P=0.002）、CCI（P=0.027）、HAART（P=0.028）和 CD4+T 细胞计数（P=0.045）有关。然而，多因素逻辑回归分析显示，HAART 与术后并发症之间无相关性。p 分期是生存时间的独立预后因素。
在我们的单臂回顾性分析中，HIV 感染的 NSCLC 患者术后并发症的危险因素是 HIV 病毒载量、CCI 和 CD4+T 细胞计数。p 分期是长期生存的预测因素。
