SURGICAL-TREATMENT OF LUNG-CANCER IN PATIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS

Background. Since January 1986, more than 20 patients have been seen a t the University of Miami/Jackson Memorial Medical Center and the Miam i Veterans Administration Medical Center with concurrent human immunod eficiency virus infection and bronchogenic carcinoma. Four of these pa tients were treated surgically with curative intent. Methods. The hist ories, records, operative reports, and pathology reports of the 4 pati ents were reviewed. Results. The 4 surgically treated patients had sta ge I T1 NO MO lung cancer. Three patients had T4 cell counts of less t han 200/mu L and were managed by lobectomy. These patients died 5, 31/ 2, and 5 months postoperatively. More recently, a fourth patient had a T4 cell count of 963/mu L and was treated with wedge resection. He is currently alive 12 months postoperatively. Conclusions. It is conclud ed that surgically treated patients with lung cancer, human immunodefi ciency virus infection, and T4 cell counts lower than 200/mu L have hi gh mortality and morbidity. Although it may be best to base surgical i ntervention on the stage of the patient's human immunodeficiency virus infection, further analysis is essential to determine which subgroup of human immunodeficiency virus-positive patients, if any, would benef it from surgical treatment of lung cancer.