Department of Urology and Lithotripsy Center, Peking University People's Hospital, Beijing, China.
Department of Urology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
BMC Infect Dis. 2022 Jul 9;22(1):605. doi: 10.1186/s12879-022-07592-z.
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.
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.
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.
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.
与普通人群相比，HIV 感染者（PLWH）患癌症的风险更高。近年来，PLWH 中肾细胞癌（RCC）的患病率逐渐增加，但有关手术后结局的相关数据很少。因此，我们评估了 HIV 阳性和阴性 RCC 患者手术后的长期结局。
这项回顾性研究纳入了 2012 年 1 月至 2021 年 1 月在我院接受手术治疗的 67 例 RCC 患者，包括 HIV 阳性和阴性患者。收集人口统计学资料、临床资料和癌症情况。以手术当天为基线。本次时间事件分析的主要终点是总生存和无进展生存。我们使用多变量 Cox 模型比较 PLWH 和 HIV 阴性患者的预后，并呈现主要终点的 Kaplan-Meier 曲线。
在 261 例连续患者中，有 18 例患者在术前放弃治疗，133 例患者数据不完整，16 例患者临床分期为 IV 期，11 例 PLWH 患者未接受抗逆转录病毒治疗，16 例患者发生转移，这些患者被排除在主要分析之外。在其余 67 例患者中，有 33 例 HIV 阳性，其余 34 例 HIV 阴性。PLWH 患者的中位总生存期为 74.9 个月（95%置信区间[CI] = 64.6 至 85.2），HIV 阴性患者为 96.4 个月（95%CI = 90.0 至 102.9）。无进展生存期分别为 66.4 个月（95%CI = 53.5 至 79.3）和 90.6 个月（95%CI = 81.1 至 100.1）。接受手术的 HIV 阳性 RCC 患者的生存时间更短（风险比[HR] = 2.8，95%CI = 1.1 至 7.0，p = 0.016），肿瘤进展发生率更高（HR = 2.7，95%CI = 1.1 至 6.8，p = 0.028）。单因素和多因素 Cox 回归分析显示，CD4 T 细胞与 CD8 T 细胞的比例较低（调整优势比 = 0.092，95%CI = 0.01 至 0.70，p = 0.022）与 PLWH 的生存较差相关。
在这项对接受手术治疗的 RCC 患者的回顾性分析中，与 HIV 阴性患者相比，PLWH 的总生存和无进展生存更差。
