Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2024; 16(1): 29-39
Published online Jan 27, 2024. doi: 10.4240/wjgs.v16.i1.29
Oncological features and prognosis of colorectal cancer in human immunodeficiency virus-positive patients: A retrospective study
Fu-Yu Yang, Fan He, De-Fei Chen, Cheng-Lin Tang, Saed Woraikat, Yao Li, Kun Qian
Fu-Yu Yang, Fan He, De-Fei Chen, Cheng-Lin Tang, Saed Woraikat, Kun Qian, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Yao Li, Department of General Surgery, Chongqing Public Health Medical Center, Chongqing 400036, China
Co-first authors: Fu-Yu Yang and Fan He.
Author contributions: Yang FY contributed to the conception and design of the study; Qian K provided the study materials and patients; Yang FY and He F wrote the first draft of the manuscript; Chen DF and He F collected and assembled the data; He F, Woraikat S, Tang CL, and Li Y contributed to the manuscript modification; all authors contributed to the manuscript writing and revision, and approved the submitted version. The reasons for designating Yang FY and He F as co-first authors are twofold. First, the research was performed as a collaborative effort, and the designation of co-first authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant paper. This also ensures effective communication and management of post-submission matters, ultimately enhancing the paper's quality and reliability. Second, Yang FY and He F contributed efforts of equal substance throughout the research process. The choice of these researchers as co-first authors acknowledges and respects this equal contribution, while recognizing the spirit of teamwork and collaboration of this study. In summary, we believe that designating Yang FY and He F as co-first authors is fitting for our manuscript as it accurately reflects our team's collaborative spirit, equal contributions, and diversity.
Supported by General Plan of the Future Medical Youth Innovation Team Development Support Plan of Chongqing Medical University, No. 03030299QC-W0007.
Institutional review board statement: This study was reviewed and approved by the Medical Ethics Committee of Chongqing Medical University (No. K2023-019). The study was carried out in accordance with the Declaration of Helsinki.
Informed consent statement: Informed consent has been waived by the Research Ethics Committee.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
Data sharing statement: The original anonymous dataset is available on request from the corresponding author at 3069443005@qq.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kun Qian, MD, PhD, Chief Doctor, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China. 3069443005@qq.com
Received: September 29, 2023
Peer-review started: September 29, 2023
First decision: November 21, 2023
Revised: November 28, 2023
Accepted: December 19, 2023
Article in press: December 19, 2023
Published online: January 27, 2024
Abstract
BACKGROUND

Due to the prolonged life expectancy and increased risk of colorectal cancer (CRC) among patients with human immunodeficiency virus (HIV) infection, the prognosis and pathological features of CRC in HIV-positive patients require examination.

AIM

To compare the differences in oncological features, surgical safety, and prognosis between patients with and without HIV infection who have CRC at the same tumor stage and site.

METHODS

In this retrospective study, we collected data from HIV-positive and -negative patients who underwent radical resection for CRC. Using random stratified sampling, 24 HIV-positive and 363 HIV-negative patients with colorectal adenocarcinoma after radical resection were selected. Using propensity score matching, we selected 72 patients, matched 1:2 (HIV-positive:negative = 24:48). Differences in basic characteristics, HIV acquisition, perioperative serological indicators, surgical safety, oncological features, and long-term prognosis were compared between the two groups.

RESULTS

Fewer patients with HIV infection underwent chemotherapy compared to patients without. HIV-positive patients had fewer preoperative and postoperative leukocytes, fewer preoperative lymphocytes, lower carcinoembryonic antigen levels, more intraoperative blood loss, more metastatic lymph nodes, higher node stage, higher tumor node metastasis stage, shorter overall survival, and shorter progression-free survival compared to patients who were HIV-negative.

CONCLUSION

Compared with CRC patients who are HIV-negative, patients with HIV infection have more metastatic lymph nodes and worse long-term survival after surgery. Standard treatment options for HIV-positive patients with CRC should be explored.

Keywords: Colorectal cancer, Human immunodeficiency virus, Propensity score matching, Oncological features, Surgical safety, Prognosis

Core Tip: This study aimed to compare the differences in oncological features, surgical safety, and prognosis between colorectal cancer (CRC) patients with and without human immunodeficiency virus (HIV) infection. HIV-positive patients with CRC had more metastatic lymph nodes and worse long-term survival compared to patients without HIV infection; however, the risk of surgery was not increased. To our knowledge, our series of 24 postoperative patients represents the largest reported study of HIV-positive patients with CRC.