HIV-related bladder cancer: A ten-year experience

BackgroundReports on bladder cancer among people living with HIV (PLWH) are very limited. In this case series, we investigated the clinical characteristics, pathology, treatments, adjuvant therapy, and survival of bladder cancer in PLWH.MethodsThis case series identified all PLWH treated for bladder cancer at our institution between 2013 and 2023 through review of medical records. Clinical data were presented as descriptive statistics. We estimated median and 1-, 3-, and 5-years cancer-specific survival using the Kaplan-Meier method and conducted univariate Cox analyses to evaluate variables associated with cancer-specific survival.ResultsTwenty PLWH underwent treatment for bladder cancer during the study period. All patients were male with a median age of 56 years. Radical cystectomy was performed in four patients (20%) and transurethral resection of bladder tumor in sixteen (80%). Adjuvant immunotherapy (tislelizumab) combined with chemotherapy (gemcitabine and cisplatin) was used in six patients after radical cystectomy. In the Kaplan-Meier analysis, the 1-, 3-, and 5-years cancer-specific survival rates of the cohort were 85%, 65%, and 60%, respectively. In univariate analysis, higher tumor stage (stage >T1 vs T1) was significantly associated with cancer-specific survival.ConclusionsGiven the relatively young age and aggressive pathological features observed in this case series, further research is warranted to determine whether targeted screening in PLWH could be beneficial. Limited data preliminarily suggest that intravesical chemotherapy with pirarubicin and adjuvant immunotherapy combined with chemotherapy may be safe and effective options for PLWH with bladder cancer; however, these observations require validation in larger studies. PLWH with muscle-invasive bladder cancer appear to have poorer cancer-specific survival.