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
Processing time: 118 Days and 0.7 Hours
ARTICLE HIGHLIGHTS
Research background

Human immunodeficiency virus (HIV) infection may accelerate the progression of colorectal cancer (CRC). Given the prolonged life expectancy and increased risk of CRC among patients with HIV infection, the prognosis and pathological features of CRC in this population should be examined. This study aimed to compare the differences in oncological features, surgical safety, and prognosis between CRC patients with and without HIV infection.

Research motivation

Differences in oncological features and prognoses between HIV-positive and -negative patients at the same stage and site have rarely been reported.

Research objectives

To compare the oncological characteristics, surgical safety, and prognoses between HIV-positive and -negative patients at the same stage and site.

Research methods

In this study, after matching the two patient groups for factors that may affect lymph node metastasis in CRC using propensity score matching (PSM), we compared the oncological characteristics, surgical safety, and prognosis of the two groups of patients. Then, Fisher’s exact, Chi-square, and Mann–Whitney U tests were applied to conduct statistical analyses on the demographic characteristics, basic preoperative profile, preoperative HIV treatment, perioperative serological indicators, surgical outcomes, oncological characteristics, and survival of the two groups of patients.

Research results

Compared to patients without HIV infection, patients with HIV infection were more reluctant to receive chemotherapy. Clinically, this group of 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. These findings suggest that the willingness and appropriate treatment of HIV-positive patients with CRC need more attention.

Research conclusions

Compared to CRC patients without HIV infection, HIV-positive patients with CRC at the same stage and site have a higher number of lymph node metastases and worse postoperative long-term survival; however, the risk of surgery is not increased.

Research perspectives

The reasons that fewer CRC patients with HIV infection receive chemotherapy need to be explored. Appropriate treatments for this patient group should be developed.