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.
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.
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.
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.
International urology and nephrology. 2016 Jun 18 [Epub ahead of print]
Sudeh Izadmehr, Michael Leapman, Adele R Hobbs, Maria Katsigeorgis, Fatima Nabizada-Pace, Seyed Behzad Jazayeri, David B Samadi
Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Department of Urology, Hofstra Northwell School of Medicine, Lenox Hill Hospital, 485 Madison Avenue, 21 Floor, New York, NY, 10022, USA., Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Department of Urology, Hofstra Northwell School of Medicine, Lenox Hill Hospital, 485 Madison Avenue, 21 Floor, New York, NY, 10022, USA., Department of Urology, Hofstra Northwell School of Medicine, Lenox Hill Hospital, 485 Madison Avenue, 21 Floor, New York, NY, 10022, USA. .