Abstract
Objective: To evaluate gynecologic cancer treatments in HIV-infected women for adherence to National Comprehensive Cancer Network (NCCN) guidelines and to describe survival by adherence to guidelines. Design: Beyond cervical cancer, there are little data on treatment and outcomes for these women. This is a retrospective cohort study of HIV-infected women with gynecologic cancers. Methods: HIV-infected women with gynecologic cancers from 2000 to 2015 were identified at two urban, comprehensive cancer centers. Chart reviews extracted demographic, HIV, and cancer-related variables. Cancer treatment was evaluated for adherence to NCCN guidelines. Overall survival was compared between those who received NCCN adherent and nonadherent cancer care. Results: Fifty-seven women were identified; 15 vulvar (26%), 26 cervical (46%), nine ovarian (16%), and seven endometrial (12%) cancers. Median time from HIV to cancer diagnosis was 8.5 years, and 88% of women were black. Thirty patients (53%) had stage I, and 27 (47%) had stage II-IV disease. Overall, 28 women (49%) received NCCN-Adherent care; 22 of 30 stage I (73%) and six of 27 stage II-IV patients (22%). Among 29 women not receiving NCCN-Adherent care, 69% were due to patient-related factors or toxicity. Among women with II-IV cancers, 48-month survival was higher in women who received NCCN-Adherent care than those who did not (60 versus 28%). Conclusion: Most HIV-infected women with advanced gynecologic cancers did not receive NCCN-Adherent care and had worse survival compared to those who did. Focus on treatment-related toxicities and patient-related barriers to cancer care are necessary in this population.
Original language | English (US) |
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Pages (from-to) | 171-177 |
Number of pages | 7 |
Journal | AIDS |
Volume | 32 |
Issue number | 2 |
DOIs | |
State | Published - Jan 14 2018 |
Keywords
- HIV
- ovarian neoplasms
- practice guideline
- survival
- uterine cervical neoplasms
- uterine neoplasms
- vulvar neoplasms
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology
- Infectious Diseases