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Outcomes Following Major Oncologic Operations for Non-AIDS-Defining Cancers in the HIV Population: A Matched Comparison to the General Population

  • Amber Chi
  • Bryan E. Adams
  • Joanna Sesti
  • Subroto Paul
  • Amber L. Turner
  • David August
  • Darren Carpizo
  • Timothy Kennedy
  • Miral Grandhi
  • H. Richard Alexander
  • Steven K. Libutti
  • Stuart Geffner
  • Russell C. LanganEmail author
Original Scientific Report
  • 15 Downloads

Abstract

Introduction

Human immunodeficiency virus (HIV) patients are living longer due to the availability of antiretroviral therapies, and non-AIDS-defining cancers are becoming more prevalent in this patient population. A paucity of data remains on post-operative outcomes following resection of non-AIDS-defining cancers in the HIV population.

Methods

The National Inpatient Sample was utilized to identify patients who underwent surgical resection for malignancy from 2005 to 2015 (HIV, N = 52,742; non-HIV, N = 11,885,184). Complications were categorized by international classification of disease (ICD)-9 diagnosis codes. Cohorts were matched on insurance, household income, zip code and urban/rural setting. Logistic regression assessed whether HIV was an independent predictor of post-operative complications.

Results

Descriptive statistics found HIV patients to have an increased rate of complications following select oncologic surgical resections. Univariate and multivariate logistic regression found HIV to only be an independent predictor of complications following pulmonary lobectomy (p = 0.011; OR 2.93, 95% CI 1.29–6.73). Length of stay was statistically longer following colectomy (2.61 days, 95% CI 1.98–3.44) in those with HIV.

Conclusions

Our findings are hypothesis generating and highlight the potential safety of major cancer surgery in the HIV population. However, care providers need be cognizant of the potential increased risk of post-operative complications following pulmonary lobectomy and the potential for increased length of stay. These findings are an initial insight into quality of care and outcomes metrics on HIV patients undergoing major cancer operations.

Notes

Author contribution

We certify that all individuals who qualify as authors have been listed; each author has participated in one or more of the following areas: conception and design of this work, the acquisition and/or analysis of data and the writing, and/or critical revision of the document. All contributing authors approve of the submission of this version of the manuscript and assert that the document represents valid work. If information derived from another source was used in this manuscript, we made appropriate acknowledgements in the document. All contributing authors take public responsibility for this work.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Société Internationale de Chirurgie 2019

Authors and Affiliations

  • Amber Chi
    • 1
  • Bryan E. Adams
    • 2
  • Joanna Sesti
    • 1
  • Subroto Paul
    • 1
  • Amber L. Turner
    • 1
  • David August
    • 1
    • 3
  • Darren Carpizo
    • 1
    • 3
  • Timothy Kennedy
    • 1
    • 3
  • Miral Grandhi
    • 1
    • 3
  • H. Richard Alexander
    • 1
    • 3
  • Steven K. Libutti
    • 3
  • Stuart Geffner
    • 1
  • Russell C. Langan
    • 1
    • 3
    Email author
  1. 1.Department of Surgery, Saint Barnabas Medical CenterRWJBarnabas HealthLivingstonUSA
  2. 2.Department of Mathematical SciencesUnited States Military AcademyWest PointUSA
  3. 3.Division of Surgical OncologyRutgers Cancer Institute of New JerseyNew BrunswickUSA

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