Surgical treatment of lung cancer in patients with human immunodeficiency virus

Background. Since January 1986, more than 20 patients have been seen at the University of Miami/Jackson Memorial Medical Center and the Miami Veterans Administration Medical Center with concurrent human immunodeficiency virus infection and bronchogenic carcinoma. Four of these patients were treated surgically with curative intent. Methods. The histories, records, operative reports, and pathology reports of the 4 patients were reviewed. Results. The 4 surgically treated patients had stage I T1 N0 M0 lung cancer. Three patients had T4 cell counts of less than 200/μL and were managed by lobectomy. These patients died 5, 3 1/2, and 5 months postoperatively. More recently, a fourth patient had a T4 cell count of 963/μL and was treated with wedge resection. He is currently alive 12 months postoperatively. Conclusions. It is concluded that surgically treated patients with lung cancer, human immunodeficiency virus infection, and T4 cell counts lower than 200/μL have high mortality and morbidity. Although it may be best to base surgical intervention on the stage of the patientʹs human immunodeficiency virus infection, further analysis is essential to determine which subgroup of human immunodeficiency virus-positive patients, if any, would benefit from surgical treatment of lung cancer.