Two lung cancer patients with HIV infection who underwent adjuvant chemotherapy followed by surgery

Background. With the advent of highly active antiretroviral therapy (HAART) for human immunodeficiency virus (HIV)-infected patients, causes of death from a wide variety of cancers have recently been increasing among this population in the United States and Europe. However, few reports have described patients with HIV who have been suffered from non-AIDS-defining cancer and undergone surgery for lung cancer in Japan. Cases. Case 1: A man in his 50s who was suffering from HIV infection from a month before his admission was given a diagnosis of lung cancer of the right upper lobe. His clinical stage was T2aN0M0. We performed video-assisted thoracoscopic surgery (VATS) lobectomy of right upper lobe and mediastinal lymph node dissection. Pathological diagnosis was adenocarcinoma (pT2aN2M0). The patient then received 4 cycles of adjuvant chemotherapy with cisplatin/vinorelbine. He has been well with no evidence of cancer recurrence for 10 months. Case 2: A man in his 70s was found to have lung cancer of the left upper lobe. His lung cancer clinical stage was T2bN0M0. He had a 20 year history of HIV infection, and underwent VATS lingular segmentectomy and mediastinal lymph node dissection because surgery was restricted by his low respiratory function. The pathological diagnosis was adenocarcinoma (pT3N2M0). Following surgery, the patient received 4 cycles of adjuvant chemotherapy with cisplatin/gemcitabine. However, intrapulmonary metastases appeared 10 months later. He has since been treated using docetaxel. Conclusion. We think that surgical treatment can be recommended for resectable lung cancer patients with HIV infection like non-HIV infectious cases. Adjuvant chemotherapy following surgery for non-small cell lung cancer was safe in these cases. However several points have not yet been established like drug interactions between antiretroviral agents and antitumor agents or adaptation for chemotherapy. The results of surgery in patients with HIV infection are satisfactory with these treatments as long as performance status, organ functions and immunological status remain good.