Original Article

Medical Oncology

, Volume 21, Issue 2, pp 109-115

First online:

Lung cancer in patients with HIV infection and review of the literature

  • Jean-Philippe SpanoAffiliated withDepartment of Medical Oncology, Pitie-salpetriere Hospital Email author 
  • , Marie-Ange MassianiAffiliated withDepartment of Lung Diseases, Foch Hospital
  • , Michele BentataAffiliated withDepartment of Infectious Diseases, Avicenne Hospital
  • , Olivier RixeAffiliated withDepartment of Medical Oncology, Pitie-salpetriere Hospital
  • , Sylvie FriardAffiliated withDepartment of Lung Diseases, Foch Hospital
  • , Philippe BossiAffiliated withDepartment of Infectious Diseases, Pitie-Salpetriere Hospital
  • , François RougesAffiliated withDepartment of Infectious Diseases, Avicenne Hospital
  • , Christine KatlamaAffiliated withDepartment of Infectious Diseases, Pitie-Salpetriere Hospital
  • , Jean-Luc BreauAffiliated withDepartment of Medical Oncology, Avicenne Hospital
    • , Jean-Francois MorereAffiliated withDepartment of Medical Oncology, Avicenne Hospital
    • , David KhayatAffiliated withDepartment of Medical Oncology, Pitie-salpetriere Hospital
    • , Louis-Jean CoudercAffiliated withDepartment of Lung Diseases, Foch Hospital

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Abstract

Background. The improved survival of patients since the use of highly active antiretroviral treatments has lead to the reporting of non-AIDS defining tumors, such as lung cancer.

Methods. Analysis of the records of 22 HIV-infected patients with lung cancer (LC) diagnosed in three hospitals located in the Paris area (France).

Results. Twenty-one patients were smokers. The patients (86% male, 14% female) had a median age of 45 yr (range, 33–64 yr). Risk factors for HIV infection were intravenous drug use in 5 patients, homosexual transmission in 10 patients, and heterosexual transmission in 7 patients. At diagnosis of LC, seven patients had previously developed a CDC-defined AIDS manifestation, the median CD4 cell count was 364/mm3 (range 20–854/mm3) and median HIV1 RNA viral load was 3000 copies/mL. The most frequent histological subtype was squamous cell carcinoma (11 cases). A stage III–IV disease was observed in 75% of the patients. Only one patient had a small-cell lung carcinoma. Twenty-one patients received combined specific therapy, of which six patients underwent surgery for the LC. The median overall survival was 7 mo. No opportunistic infections occurred during LC therapy.

Conclusions. LC occurs at a young age in HIV-infected smokers. LC is not associated with severe immunodeficiency. The prognosis is poor because of their initial extensive disease and a poor response to therapy. However, surgery appears to improve outcome in much the same way as in the general population.

Key Words

Lung cancer HIV infection clinical characteristics outcome therapy survival