Methods: We conducted a retrospective review of HIV patients with prostate cancer seen at the Veterans Affairs Medical Center in Miami, Florida from 2007 to 2016. Our aim was to determine the clinical characteristics and treatment patterns of prostate cancer in HIV patients. Data was analyzed in SPSS 22, New York, USA.
Results: There were 1752 HIV patients treated in our institution. We identified 45 (2.56%) patients with prostate cancer. The mean age was 62.09 (SD ± 5.99) years. Most patients were African American (73.3%). Alcohol consumption, smoking and drug use were reported by 53.3%, 51.1% and 31.1% of patients respectively. The most common comorbidities were hypertension (68.9%) and hyperlipidemia (51.1%). Most patients (80%) had undetectable HIV viral load. The mean CD4 count was 576.84 (SD ± 241.12) cells/uL. The majority of patients (88.89%) were on antiretroviral therapy.
Most patients (86.7%) were referred for prostate biopsy after an elevated PSA level. Lower urinary symptoms were reported by 51% of patients. By digital rectal exam, 60% presented prostate enlargement and 13.3% nodules or masses. The mean PSA and Gleason score were 13.96 (SD ± 14.43) and 7.07 (SD ± 1.01) respectively. Most patients were at clinical stage T1c N0 M0 (86.7%). They were treated with surgical prostatectomy in 37.8% of cases (radical prostatectomy in 20% and robotic prostatectomy in 17.8%) and radiation therapy in 55.6% of cases (along with antiandrogen therapy in 33%). Androgen deprivation therapy alone or active surveillance was used in 6.7%. After a mean follow-up of 42.3 (SD ± 35.55) months, most patients were alive (88.9%). There were 5 deaths, 4 related to other malignancies and only one due to metastatic prostate cancer.
Conclusion: Most HIV-infected veterans were diagnosed with prostate cancer at early stages. HIV status does not seem to affect the prognosis of patients with prostate cancer, which was demonstrated by the good outcomes observed in our study.
J. Baez Presser,
J. Gonzales Zamora, None