Robot-assisted laparoscopic radical prostatectomy in men with human immunodeficiency virus

• Published in: Prostate cancer and prostatic diseases Vol. 13; no. 4; pp. 328 - 332
• Main Authors: Silberstein, J L, Parsons, J K, Palazzi-Churas, K, Downs, T M, Sakamoto, K, Derweesh, I H, Woldrich, J, Kane, C J
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.12.2010; Nature Publishing Group
• Subjects: 631/250/255/1901; 692/699/67/589/466; 692/700/565/545; Adult; Aged; Antiretroviral agents; Biomedical and Life Sciences; Biomedicine; Cancer Research; Cancer surgery; Carcinoma - complications; Carcinoma - surgery; Care and treatment; CD4 antigen; Chi-square test; Complications; Demographics; Demography; Diagnosis; Health aspects; Highly active antiretroviral therapy; HIV; HIV - physiology; HIV Infections - complications; HIV Infections - surgery; HIV patients; Human immunodeficiency virus; Humans; Immune system; Laparoscopy; Laparoscopy - instrumentation; Laparoscopy - methods; Length of Stay - statistics & numerical data; Male; Medical examination; Middle Aged; Non-Hodgkin's lymphomas; original-article; Patient outcomes; Patients; Postoperative Complications - epidemiology; Prostate cancer; Prostatectomy; Prostatectomy - instrumentation; Prostatectomy - methods; Prostatic Neoplasms - complications; Prostatic Neoplasms - surgery; Risk factors; Robotic surgery; Robotics - methods; Robots; Statistical tests; Transfusion; Tumors; Urological surgery; United States; AIDS; radical prostatectomy; HIV; robot-assisted laparoscopic prostatectomy; HAART
• ISSN: 1365-7852; 1476-5608
• DOI: 10.1038/pcan.2010.35

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.