Kaposi's Sarcoma: Evaluation of Clinical Features, Treatment Outcomes, and Prognosis in a Single-Center Retrospective Case Series

CANCERS(2024)

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摘要
Simple Summary Kaposi's sarcoma (KS) is a low-grade, vascular tumor associated with human herpesvirus 8 (HHV8) infection. There are four widely recognized types of KS including classic, endemic, iatrogenic, and epidemic forms. Although in most cases, KS is an indolent disease limited to the skin, it may have a more aggressive behavior resulting in locally aggressive disease and/or involving the mucosae or visceral organs, especially in immunosuppressed patients. The main risk factors are HHV-8 infection and immunosuppression status. The treatment is very heterogenous, because there is still no unified strategy for the treatment of KS. The aim of this study is to describe the demographic and clinical features, treatment outcomes, and prognosis of a cohort of patients affected by KS treated at the University Hospital of Padua (AOPD) and at the Veneto Institute of Oncology (IOV) between 1993 and 2022.Abstract Kaposi's sarcoma (KS) is a rare angioproliferative tumor classified in four different clinical-epidemiological forms. The diagnosis is based on histopathological and immunohistochemical analyses. The treatment is heterogeneous and includes several local and systemic therapeutic strategies. Methods: This is a retrospective cohort study including 86 KS patients treated between 1993 and 2022 at the University Hospital of Padua (AOPD) and at the Veneto Institute of Oncology (IOV). The data were extracted from an electronic database. Survival curves were generated using the Kaplan-Meier method, and Cox regression models were employed to explore associations with overall and disease-free survival. The male sex (89.53%), classical variant (43.02%), and cutaneous involvement (77.9%) were predominant. More than 61.6% of patients received a single treatment. Surgery, antiretroviral therapy, and chemotherapy were the mostly adopted approaches. A persistent response was observed in approximately 65% of patients, with a 22% relapse rate (at least 2 years). The overall survival ranges from 90 to 70% at 2 to 10 years after the diagnosis. Iatrogenic KS demonstrated a higher mortality (52.9%). This study reflects our experience in the management of KS. Comorbidities are very frequent, and treatments are heterogeneous. A multidisciplinary approach involving multiple referral specialists is essential for the appropriate management of this disease during diagnosis, treatment, and follow-up.
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关键词
Kaposi's sarcoma,vascular sarcoma,iatrogenic disease,HIV-related disease,immunosuppression status
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