Clinical presentation and outcome of colorectal cancer in HIV-positive patients

A clinical case-control study

Massimiliano Berretta, Alessandro Cappellani, Fabrizio Di Benedetto, Arben Lleshi, Renato Talamini, Vincenzo Canzonieri, Ernesto Zanet, Alessandra Bearz, Guglielmo Nasti, Teresa Lacchin, Salvatore Berretta, Rossella Fisichella, Luca Balestreri, Augusta Torresin, Immacolata Izzi, Patrizia Ortolanik, Umberto Tirellia

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

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: ≥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.

Original languageEnglish
Pages (from-to)319-324
Number of pages6
JournalOnkologie
Volume32
Issue number6
DOIs
Publication statusPublished - Jun 2009

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Case-Control Studies
Colorectal Neoplasms
HIV
Confidence Intervals
Odds Ratio
Survival
HIV-2
Registries
Neoplasms
Acquired Immunodeficiency Syndrome
Multivariate Analysis
Databases

Keywords

  • Colorectal cancer
  • HIV

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Hematology

Cite this

Clinical presentation and outcome of colorectal cancer in HIV-positive patients : A clinical case-control study. / Berretta, Massimiliano; Cappellani, Alessandro; Di Benedetto, Fabrizio; Lleshi, Arben; Talamini, Renato; Canzonieri, Vincenzo; Zanet, Ernesto; Bearz, Alessandra; Nasti, Guglielmo; Lacchin, Teresa; Berretta, Salvatore; Fisichella, Rossella; Balestreri, Luca; Torresin, Augusta; Izzi, Immacolata; Ortolanik, Patrizia; Tirellia, Umberto.

In: Onkologie, Vol. 32, No. 6, 06.2009, p. 319-324.

Research output: Contribution to journalArticle

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, Ortolanik, P & Tirellia, U 2009, 'Clinical presentation and outcome of colorectal cancer in HIV-positive patients: A clinical case-control study', Onkologie, vol. 32, no. 6, pp. 319-324. https://doi.org/10.1159/000215719
Berretta, Massimiliano ; Cappellani, Alessandro ; Di Benedetto, Fabrizio ; Lleshi, Arben ; Talamini, Renato ; Canzonieri, Vincenzo ; Zanet, Ernesto ; Bearz, Alessandra ; Nasti, Guglielmo ; Lacchin, Teresa ; Berretta, Salvatore ; Fisichella, Rossella ; Balestreri, Luca ; Torresin, Augusta ; Izzi, Immacolata ; Ortolanik, Patrizia ; Tirellia, Umberto. / Clinical presentation and outcome of colorectal cancer in HIV-positive patients : A clinical case-control study. In: Onkologie. 2009 ; Vol. 32, No. 6. pp. 319-324.
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abstract = "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: ≥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.",
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AU - Di Benedetto, Fabrizio

AU - Lleshi, Arben

AU - Talamini, Renato

AU - Canzonieri, Vincenzo

AU - Zanet, Ernesto

AU - Bearz, Alessandra

AU - Nasti, Guglielmo

AU - Lacchin, Teresa

AU - Berretta, Salvatore

AU - Fisichella, Rossella

AU - Balestreri, Luca

AU - Torresin, Augusta

AU - Izzi, Immacolata

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N2 - 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: ≥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.

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