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

Prostate Cancer and Prostatic Diseases volume 13, pages 328–332 (2010)Cite this article

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Abstract

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 (χ2, 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 (<50); mean CD4 count was 634 cells per mm3. HIV-positive men were younger (54 versus 62 years, P=0.010) and less likely to be white (P=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=0.031) and ileus (P=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=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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Author notes

  1. J L Silberstein and T M Downs: Since the completion of this work, Dr Downs's affiliation has been changed to Department of Urology, University of Wisconsin, Madison, WI, USA; and Dr Silberstein's has been changed to Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.

Authors and Affiliations

  1. Division of Urology, University of California San Diego, San Diego, CA, USA

    J L Silberstein, J K Parsons, T M Downs, K Sakamoto, I H Derweesh, J Woldrich & C J Kane

  2. Urologic Cancer Unit, Moores University of California San Diego Cancer Center, La Jolla, CA, USA

    J L Silberstein, J K Parsons, K Palazzi-Churas, T M Downs, I H Derweesh, J Woldrich & C J Kane

  3. Section of Urology, VA San Diego Medical Center, La Jolla, CA, USA

    J L Silberstein, J K Parsons, T M Downs, K Sakamoto, I H Derweesh, J Woldrich & C J Kane

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  1. J L Silberstein
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  4. T M Downs
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Correspondence to J L Silberstein.

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Competing interests

Dr Kane receives compensation as a consultant for Intuitive Surgical and is on the Scientific Advisory Board for Soar Biodynamics. Dr Derweesh receives compensation as a consultant for Ethicon and as a consultant and Advisory Board member of GTX. Dr Parsons receives compensation as a lecturer for AMS and has financial holdings in Urigen. The remaining authors declare no conflict of interest.

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Silberstein, J., Parsons, J., Palazzi-Churas, K. et al. Robot-assisted laparoscopic radical prostatectomy in men with human immunodeficiency virus. Prostate Cancer Prostatic Dis 13, 328–332 (2010). https://doi.org/10.1038/pcan.2010.35

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