Outcome of patients with HIV-related germ cell tumours: a case-control study.
Testicular germ cell tumour (GCT) is not an AIDS-defining illness despite an increased incidence in men with HIV infection. We performed a matched case-control study comparing outcomes in HIV-positive men and the general population with GCT, using three age and stage matched controls for each case. There was no difference in the 5-year GCT-free survival between cases and controls. However, overall survival was significantly decreased in the cases (log rank P=0.03). HIV was responsible for 70% of this mortality. The relapse-free survival for stage I patients treated with orchidectomy and surveillance was not affected by HIV status (log rank P=0.68). There was no difference in disease free survival in patients with metastatic disease (log rank P=0.78). The overall survival has not improved since the introduction of highly active antiretroviral therapy (log rank P=0.4). Thus, HIV-related GCT is not more aggressive than GCT in the general population.
Powles
T
T
Department of Oncology, Chelsea and Westminster Hospital, Fulham Road, London SW10 9NH, UK.
Bower
M
M
Shamash
J
J
Stebbing
J
J
Ong
J
J
Daugaard
G
G
De Ruiter
A
A
Johnson
M
M
Fisher
M
M
Anderson
J
J
Nelson
M
M
Gazzard
B
B
Oliver
T
T
D000328:Adult; D016022:Case-Control Studies; D018572:Disease-Free Survival; D018237:Germinoma / Q000473:pathology* / Q000601:surgery / Q000821:virology*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009919:Orchiectomy; D011379:Prognosis; D013736:Testicular Neoplasms / Q000473:pathology* / Q000601:surgery / Q000821:virology*