- 189: Onkologie. 2009 Jun;32(6):319-24. Epub 2009 May 14
Comment in:
Onkologie. 2009 Jun;32(6):306-7.
Clinical presentation and outcome of colorectal cancer in HIV-positive patients: a clinical case-control study.
Berretta M, Cappellani A, Di Benedetto F, Lleshi A, Talamini R, Canzonieri V, Zanet E, Bearz A, Nasti G, Lacchin T, Berretta S, Fisichella R, Balestreri L, Torresin A, Izzi I, Ortolani P, Tirelli U.
Division of Medical Oncology A, National Cancer Institute, Aviano, Italy. mberretta@cro.it
BACKGROUND: Data on colorectal cancer (CRC) in HIV-positive patients are limited. The study objective was to investigate and compare clinical presentation and outcome between HIV-positive and HIV-negative CRC patients. PATIENTS AND METHODS: Between September 1985 and November 2003 we identified 27 cases of HIV-positive CRC patients from the cancer registry database - Italian Cooperative Group AIDS and Tumours (GICAT); the clinical presentation/outcome information was retrieved. Each HIV-positive patient from our institution was randomly matched (ratio 1:2) with HIV-negative patients (54 controls) based on age, sex, and year of diagnosis in the same time period. Differences in clinical presentation, treatment, and overall survival were assessed. RESULTS: Of 1130 HIV-negative CRC patients, 54 were identified and matched with 27 HIV-positive patients. Compared with the HIV-negative patients, the HIV-positive patients had a higher risk of lower performance status (PS: > or =2) (odds ratio (OR) = 14.4; 95% confidence interval (CI): 3.6-57.7), a higher risk of unfavorable Dukes' stage (D) (OR = 4.9; 95% CI: 1.8-13.5), and a higher risk of poor grading (G3-G4) (OR = 5.0; 95% CI: 1.9-13.4). Median overall follow-up was 27 months (range: 2-212). At multivariate analysis, the only characteristics that significantly reduced the survival of the CRC patients were: HIV-positive status (hazard ratio (HR): 2.4; 95% CI: 1.1-5.2) and Dukes' stage D (HR: 3.7; 95% CI: 1.9-7.1). CONCLUSION: Our data show that HIV-positive CRC patients compared to HIV-negative patients have a poorer PS, an unfavorable Dukes' stage, higher grading and shorter survival. Copyright 2009 S. Karger AG, Basel.