Clinical characteristics and outcomes of HIV-seropositive men treated with surgery for prostate cancer.
OBJECTIVE
The natural history and optimal management strategy for men with human immunodeficiency virus (HIV) and prostate cancer remain to be definitively characterized. This study was conducted to evaluate the clinical characteristics and outcomes of HIV-seropositive men treated with robotic-assisted radical laparoscopic prostatectomy for localized prostate cancer.


METHODS
After Institutional Review Board approval, a prospective database of 2175 operative cases of clinically localized prostate adenocarcinoma was reviewed. Thirteen patients were identified as HIV-positive. Tumor characteristics, operative outcomes, postoperative outcomes, histology (Gleason score), local invasion, biochemical recurrence, and surgical complications were compared with HIV-negative patients.


RESULTS
There were no preoperative demographic differences between the HIV-positive and HIV-negative patients. HIV-positive patients had higher prostate specific antigen (PSA) levels at time of diagnosis which was not statistically significant. However, HIV-positive patients had higher D'Amico risk assessment (p < 0.05). There was no postoperative complication. HIV-positive patients treated with robotic prostatectomy had similarly favorable perioperative and short-term biochemical recurrence-free survival outcomes.


CONCLUSIONS
Our findings show that minimally invasive prostatectomy can be safely considered as a therapeutic option in otherwise eligible HIV-positive patients with clinically significant prostate cancer. Further research is necessary to outline a diagnostic and treatment guideline for HIV-positive men in detection and treatment of prostate cancer.
Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.|University of California San Francisco School of Medicine, San Francisco, CA, USA.
Sudeh
S
Izadmehr
Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.|University of California San Francisco School of Medicine, San Francisco, CA, USA.
Michael
M
Leapman
Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.|University of California San Francisco School of Medicine, San Francisco, CA, USA.|Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.|Department of Urology, Hofstra Northwell School of Medicine, Lenox Hill Hospital, 485 Madison Avenue, 21 Floor, New York, NY, 10022, USA.
Adele R
AR
Hobbs
Department of Urology, Hofstra Northwell School of Medicine, Lenox Hill Hospital, 485 Madison Avenue, 21 Floor, New York, NY, 10022, USA.
Maria
M
Katsigeorgis
Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.|University of California San Francisco School of Medicine, San Francisco, CA, USA.
Fatima
F
Nabizada-Pace
Department of Urology, Hofstra Northwell School of Medicine, Lenox Hill Hospital, 485 Madison Avenue, 21 Floor, New York, NY, 10022, USA.
Seyed Behzad
SB
Jazayeri
Department of Urology, Hofstra Northwell School of Medicine, Lenox Hill Hospital, 485 Madison Avenue, 21 Floor, New York, NY, 10022, USA. robotmd@yahoo.com.
David B
DB
Samadi
D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology / Q000601:surgery; D000368:Aged; D018572:Disease-Free Survival; D006679:HIV Seropositivity / Q000150:complications; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D010043:Outcome and Process Assessment, Health Care; D011467:Prostate / Q000473:pathology; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods; D011471:Prostatic Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery; D018570:Risk Assessment; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D014481:United States
HIV; Prostate cancer; Prostate-specific antigen; Robotic-assisted laparoscopic radical prostatectomy