To compare differences in clinical characteristics and outcomes between patients with and without human immunodeficiency virus (HIV) infection in light of robot-assisted laparoscopic radical prostatectomy (RALRP) as the most common surgical technique for prostate cancer. Previous data on perioperative complication rates of RALRP in HIV(+) patients are limited by small sample size.
The National Inpatient Sample database from 2008 to 2014 was used to query prostate cancer patients who underwent RALRP. HIV(+) patients were identified through ICD9 codes 042, 043, 044, V08 and 079.53. Intraoperative and postoperative complications, rate of blood transfusion, in-hospital mortality, prolonged length of stay and total cost were compared by univariate, multivariate regression and 1:4 propensity score matched analyses.
Overall, 270,319 weighted patients undergoing RALRP were identified, among whom 546 (0.20%) patients were diagnosed with HIV. Patients with HIV were younger, less likely to be white and had more comorbidities. Multivariable regression analysis revealed that HIV(+) patients had significantly increased genitourinary complications (odds ratio [OR]: 3.31; 95% confidence interval [CI]: 1.03-10.68) and miscellaneous surgical events (OR 3.19; 95% CI 1.26-8.08). There were no differences in potentially life-threatening cardiac, respiratory and vascular events between patients with and without HIV after RALRP. Propensity score matched analysis yielded similar results.
Our findings suggest that patients who underwent RALRP with HIV did not experience higher risk of potentially life-threatening postoperative complications. RALRP could be safely considered as a surgical treatment for HIV(+) patients with prostate cancer.
International urology and nephrology. 2019 Nov 02 [Epub ahead of print]
Hedong Han, Chen Ye, Zhongjun Tang, Yingyi Qin, Yiming Ruan, Yang Cao, Jia He
Department of Health Statistics, Second Military Medical University, No. 800 Xiangyin Road, Shanghai, 200433, China., Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China., Department of Ophthalmology, Minhang Hospital, Fudan University, Shanghai, China., Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 701 82, Örebro, Sweden., Department of Health Statistics, Second Military Medical University, No. 800 Xiangyin Road, Shanghai, 200433, China. .