Published online May 10, 2013. doi: 10.5306/wjco.v4.i2.52
Revised: March 29, 2013
Accepted: April 9, 2013
Published online: May 10, 2013
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AIM: To evaluate the outcomes and potential prognostic factors in patients with non-acquired immunodeficiency syndrome (AIDS)-related Kaposi’s sarcoma (KS).
METHODS: Patients with histologically proven non-AIDS-related KS treated with systemic chemotherapy were included in this retrospective analysis. In some cases, the human herpes virus 8 status was assessed by immunohistochemistry. The patients were staged according to the Mediterranean KS staging system. A multivariable model was constructed using a forward stepwise selection procedure. A P value < 0.05 was considered statistically significant, and all tests were two-sided.
RESULTS: Thirty-two cases were included in this analysis. The average age at diagnosis was 70 years, with a male/female ratio of approximately 2:1. Eighty-four percent of the cases had classic KS. All patients received systemic chemotherapy containing one of the following agents: vinca alkaloid, taxane, and pegylated liposomal doxorubicin. Ten patients (31.5%) experienced a partial response, and a complete response was achieved in four patients (12.4%) and stable disease in sixteen cases (50%). Two patients (6.2%) were refractory to the systemic treatment. The median progression-free survival (PFS) was 11.7 mo, whereas the median overall survival was 28.5 mo. At multivariate analysis, the presence of nodular lesions (vs macular lesions only) was significantly related to a lower PFS (hazard ratio: 3.09; 95%CI: 1.18-8.13, P = 0.0133).
CONCLUSION: Non-AIDS-related KS appears mostly limited to the skin and is well-responsive to systemic therapies. Our data show that nodular lesions may be associated with a shorter PFS in patients receiving chemotherapy.
Core tip: Non-acquired immunodeficiency syndrome (AIDS)-related Kaposi’s sarcoma (KS) is usually relatively benign, with an indolent disease course. It appears to be highly responsive to a wide variety of chemotherapy agents, including pegylated liposomal doxorubicin, vinca-alkaloids, etoposide and taxanes. However, factors predictive of progression-free survival are lacking. In our series of 32 patients with non-AIDS-related KS, we showed that presence of nodular lesions (vs macular lesions only) was associated with a 3-fold increased risk of progression. If confirmed by further studies, such a finding may be useful to improve the therapeutic strategy for this disease at the individual level.