Robot-assisted laparoscopic radical prostatectomy in men with human immunodeficiency virus.
The aim of this study is to evaluate the outcomes of robot-assisted laparoscopic prostatectomy (RALP) in prostate cancer (PCa) patients with human immunodeficiency virus (HIV). This is a prospective cohort study of HIV patients undergoing RALP, comparing the demographics, tumor characteristics, complications, and short-term oncological outcomes of HIV-positive men to HIV-negative men using univariate (χ(2), Mann-Whitney test) and multivariable (logistic regression) analyses. From 2007 to 2010, 298 men underwent RALP, 8 of whom were known to be HIV positive. Preoperatively, all eight were taking highly active antiretroviral therapy (HAART) and had undetectable viral loads (<50); mean CD4 count was 634 cells per mm(3). HIV-positive men were younger (54 versus 62 years, P=0.010) and less likely to be white (P=0.007). There were no significant differences between groups with respect to clinical staging, pathological and oncological outcomes or most complication rates. However, the prevalence of perioperative transfusions (P=0.031) and ileus (P=0.021) were higher in HIV-positive patients. HIV remained significantly associated with risk of transfusion after adjustment for age, race, Gleason sum and clinical T stage (P=0.002). After a median of 2.6 (range 0.03-19.2) months of follow-up, PSA remained undetectable in all eight HIV patients. These data suggest that RALP is safe for, and demonstrates short-term oncological efficacy in, HIV-positive patients with PCa.
Silberstein
J L
JL
Division of Urology, University of California San Diego, San Diego, CA 92103-8897, USA. leparker@ucsd.edu
Parsons
J K
JK
Palazzi-Churas
K
K
Downs
T M
TM
Sakamoto
K
K
Derweesh
I H
IH
Woldrich
J
J
Kane
C J
CJ
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000150:complications / Q000601:surgery*; D006678:HIV / Q000502:physiology; D015658:HIV Infections / Q000150:complications / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011468:Prostatectomy / Q000295:instrumentation / Q000379:methods*; D011471:Prostatic Neoplasms / Q000150:complications / Q000601:surgery*; D012371:Robotics / Q000379:methods*