Gynecologic cancer in HIV-infected women: Treatment and outcomes in a multi-institutional cohort

Kimberly Levinson, David J. Riedel, Laureen S. Ojalvo, Wesley Chan, Ana M. Angarita, Amanda Nickles Nickles Fader, Anne Rositch

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)171-177
Number of pages7
JournalAIDS
Volume32
Issue number2
DOIs
StatePublished - 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

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