학술논문

Short-term outcomes for lung cancer resection surgery in HIV infection.
Document Type
article
Source
AIDS. 33(8)
Subject
HIV/AIDS
Lung Cancer
Cancer
Infectious Diseases
Prevention
Patient Safety
Lung
Clinical Research
6.4 Surgery
Aetiology
2.4 Surveillance and distribution
Evaluation of treatments and therapeutic interventions
Infection
Good Health and Well Being
Aged
Cohort Studies
Female
HIV Infections
Humans
Lung Neoplasms
Male
Middle Aged
Survival Analysis
Treatment Outcome
lung cancer
lung cancer surgery
non-AIDS malignancy
nonsmall cell lung cancer
surgical outcomes
Veterans Aging Cohort Study
Biological Sciences
Medical and Health Sciences
Psychology and Cognitive Sciences
Virology
Language
Abstract
ObjectiveLung cancer is the leading cause of cancer death in people living with HIV (PWH). Surgical resection is a key component of potentially curative treatment regimens for early-stage lung cancers, but its safety is unclear in the setting of HIV. From a national cohort, we assessed potential differences in the risk of major lung cancer surgery complications by HIV status.DesignWe linked clinical and cancer data from the Veterans Aging Cohort Study (VACS) and Veterans Affairs Corporate Data Warehouse to outcomes from the Veterans Affairs Surgical Quality Improvement Program (VASQIP) and identified 8371 patients (137 PWH, 8234 uninfected) who underwent lung cancer surgeries between 2000 and 2016.MethodsWe compared rates of 15 major short-term surgical complications by HIV status.ResultsUse of surgical resection for early-stage lung cancer did not differ by HIV status. Lung cancer surgery postoperative (30-day) mortality was 2.0% for PWH and did not differ by HIV status (P = 0.9). Pneumonia was the most common complication for both PWH and uninfected veterans, but did not differ significantly in prevalence between groups (11.0% for PWH versus 9.4%; P = 0.5). The frequency of complications did not differ by HIV status for any complication (all P > 0.3). There were no significant predictors of postoperative complications for PWH.ConclusionsIn a national antiretroviral-era cohort of lung cancer patients undergoing surgical lung resection, short-term outcomes after surgery did not differ significantly by HIV status. Concerns regarding short-term surgical complications should have limited influence on treatment decisions for PWH with lung cancer.