Approach to management of clinically localized prostate cancer in patients with human immunodeficiency virus

Levinson, Adam W.; Nagler, Eli A.; Lowe, Franklin C.

doi:10.1016/j.urology.2004.08.053

Cited by 44 publications

(39 citation statements)

References 10 publications

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“…[19][20] Radical retropubic prostatectomy, 21 laparoscopic radical prostatectomy, 22 cryosurgery, 22 external beam radiation therapy, 23 brachytherapy 24 and active surveillance 22 have been reported for HIVpositive men with localized PCa and found to be generally safe and efficacious in the short term. 17 The oncological risk posed by PCa in the HIV-positive cohort did not differ significantly from the non-HIVpositive cohort, based on a variety of prognostic data including PSA value, clinical tumor stage, biopsy Gleason sum, D'Amico risk stratification and pathological tumor grade or stage.…”

Section: Ralp In Men With Hiv Jl Silberstein Et Almentioning

confidence: 99%

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

Silberstein

Parsons

Palazzi-Churas

et al. 2010

Prostate Cancer Prostatic Dis

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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 (v 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 (o50); mean CD4 count was 634 cells per mm 3 . HIV-positive men were younger (54 versus 62 years, P ¼ 0.010) and less likely to be white (P ¼ 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 ¼ 0.031) and ileus (P ¼ 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 ¼ 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.

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Section: Ralp In Men With Hiv Jl Silberstein Et Almentioning

confidence: 99%

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

Silberstein

Parsons

Palazzi-Churas

et al. 2010

Prostate Cancer Prostatic Dis

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show abstract

“…It has been hypothesized that reports of lower incidence of PCa in HIV positive individuals may be due to decreased screening of this group. 16,23 Detection Current PCa screening requires digital rectal exam and PSA determination. Screening protocols have unquestionably led to increased detection of cancer and a migration to lower-stage and lower-volume tumors.…”

Section: Prostate Cancermentioning

confidence: 99%

“…Levinson et al 16 performed a retrospective analysis of 10 patients with HIV and localized PCa who presented to a single urologist over a 2-year period. The age at diagnosis of PCa ranged from 41-69 years (mean 54 years); PSA ranged from 4.5-19.9 ng ml À1 .…”

Section: Different Treatments Of Study Populationsmentioning

confidence: 99%

“…The two patients who elected watchful waiting had stable PSA levels without progression at last follow-up and the eight patients who underwent intervention had PSA levels lower than baseline. 16 Pantanowitz et al 10 recently performed a retrospective multi-institutional study involving HIV-positive men with PCa. They identified 17 patients with HIV and PCa; 13 were known to be HIV-positive before being diagnosed with PCa (range 2-20 years, mean 8.5 years), 2 were found to be HIV-positive years after a diagnosis of PCa and in 2 patients HIV status could not be determined at the time of PCa diagnosis.…”

Section: Different Treatments Of Study Populationsmentioning

confidence: 99%

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HIV and prostate cancer: a systematic review of the literature

Silberstein

Downs

Lakin

et al. 2008

Prostate Cancer Prostatic Dis

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Malignancy occurs with increased frequency in the HIV-positive population. The true incidence of prostate cancer in this population is unknown. In the few cases that have been presented in the literature, prostate cancer in HIV-positive men appears to behave much like it does in HIV-negative men. Prostate cancer is the most common malignancy in men and the second leading cause of cancer death. Approximately 800 000 men in the United States are HIV positive, and innovative therapies have dramatically improved survival. HIV disproportionately impacts ethnic groups with increased risk of prostate cancer and has been associated with increases in the incidence of certain malignancies. Despite the high prevalence of both diseases, there is relatively little literature about prostate cancer in HIV-positive patients. There is no consensus on how to screen or treat this patient population. We review the literature with regards to incidence, screening, treatment, and outcomes of this poorly characterized population. We briefly discuss the impact of highly active antiretroviral therapy and testosterone supplementation in the development of prostate cancer. A systematic review of the literature was conducted using MEDLINE key words 'HIV,' 'prostate,' 'prostate cancer' and 'AIDS.' Manual bibliographic review of cross-referenced items was also performed. A total of 176 unique abstracts and publications were reviewed; many authors provided data on the incidence of HIV and various malignancies including prostate cancer. Twelve unique publications providing detailed information on 60 patients with HIV and prostate cancer were identified. Prostate cancer is a common malignancy in HIV-positive men. With improved therapies for HIV and increasing survival, the importance for screening and treating prostate cancer is increasing. Acute outcomes of treatment do not demonstrate increased acute morbidity; however long-term outcomes have not been reported.

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“…Some clinicians believe that laparoscopic or robot-assisted surgery should be performed when possible to minimize the risk of postsurgery complications. 91 In a meta-analysis of 12 publications providing detailed information on 60 patients with HIV and prostate cancer, early outcomes of treatment did not demonstrate increased acute morbidity; however, long-term outcomes have not been reported.…”

Section: Prostate Cancermentioning

confidence: 98%