title: Clinical presentation and outcome of colorectal cancer in HIV-positive patients: a clinical case-control study.
abstract: BACKGROUND
  Data on colorectal cancer (CRC) in HIV-positive patients are limited. The study objective was to investigate and compare clinical presentation and outcome between HIV-positive and HIV-negative CRC patients.
  
  
  METHODS
  Between September 1985 and November 2003 we identified 27 cases of HIV-positive CRC patients from the cancer registry database - Italian Cooperative Group AIDS and Tumours (GICAT); the clinical presentation/outcome information was retrieved. Each HIV-positive patient from our institution was randomly matched (ratio 1:2) with HIV-negative patients (54 controls) based on age, sex, and year of diagnosis in the same time period. Differences in clinical presentation, treatment, and overall survival were assessed.
  
  
  RESULTS
  Of 1130 HIV-negative CRC patients, 54 were identified and matched with 27 HIV-positive patients. Compared with the HIV-negative patients, the HIV-positive patients had a higher risk of lower performance status (PS: > or =2) (odds ratio (OR) = 14.4; 95% confidence interval (CI): 3.6-57.7), a higher risk of unfavorable Dukes' stage (D) (OR = 4.9; 95% CI: 1.8-13.5), and a higher risk of poor grading (G3-G4) (OR = 5.0; 95% CI: 1.9-13.4). Median overall follow-up was 27 months (range: 2-212). At multivariate analysis, the only characteristics that significantly reduced the survival of the CRC patients were: HIV-positive status (hazard ratio (HR): 2.4; 95% CI: 1.1-5.2) and Dukes' stage D (HR: 3.7; 95% CI: 1.9-7.1).
  
  
  CONCLUSIONS
  Our data show that HIV-positive CRC patients compared to HIV-negative patients have a poorer PS, an unfavorable Dukes' stage, higher grading and shorter survival.
authors.affiliation: Division of Medical Oncology A, National Cancer Institute, Aviano, Italy. mberretta@cro.it
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Berretta
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cappellani
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Di Benedetto
authors.forename: Arben
authors.initials: A
authors.lastname: Lleshi
authors.forename: Renato
authors.initials: R
authors.lastname: Talamini
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Canzonieri
authors.forename: Ernesto
authors.initials: E
authors.lastname: Zanet
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bearz
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Nasti
authors.forename: Teresa
authors.initials: T
authors.lastname: Lacchin
authors.forename: Salvatore
authors.initials: S
authors.lastname: Berretta
authors.forename: Rossella
authors.initials: R
authors.lastname: Fisichella
authors.forename: Luca
authors.initials: L
authors.lastname: Balestreri
authors.forename: Augusta
authors.initials: A
authors.lastname: Torresin
authors.forename: Immacolata
authors.initials: I
authors.lastname: Izzi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Ortolani
authors.forename: Umberto
authors.initials: U
authors.lastname: Tirelli
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000401:mortality*; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000401:mortality*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate