Brief Article
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World J Clin Oncol. May 10, 2013; 4(2): 52-57
Published online May 10, 2013. doi: 10.5306/wjco.v4.i2.52
Non-AIDS-related Kaposi's sarcoma: A single-institution experience
Pasquale Rescigno, Rossella Di Trolio, Carlo Buonerba, Gaia De Fata, Piera Federico, Davide Bosso, Antonella Virtuoso, Michela Izzo, Tania Policastro, Luca Vaccaro, Gianfranco Cimmino, Francesco Perri, Elide Matano, Mario Delfino, Sabino De Placido, Giovannella Palmieri, Giuseppe Di Lorenzo
Pasquale Rescigno, Rossella Di Trolio, Carlo Buonerba, Piera Federico, Davide Bosso, Antonella Virtuoso, Michela Izzo, Tania Policastro, Luca Vaccaro, Francesco Perri, Elide Matano, Sabino De Placido, Giovannella Palmieri, Giuseppe Di Lorenzo, Genitourinary Cancer Section and Rare-Cancer Center, Medical Oncology Division, University Federico II, 80131 Napoli, Italy
Gaia De Fata, Gianfranco Cimmino, Mario Delfino, Department of Dermatology, University Federico II of Naples, 80131 Napoli, Italy
Author contributions: Rescigno P, Di Trolio R and Di Lorenzo G contributed to the conception and design; Di Trolio R, Buonerba C, De Fata G, Federico P, Bosso D, Virtuoso A, Izzo M, Policastro T, Vaccaro L, Cimmino G, Perri F, Matano E, Delfino M and Palmieri G contributed to the acquisition of data; Buonerba C performed the statistical analysis; Rescigno P, Buonerba C, De Placido S and Di Lorenzo G contributed to drafting and revising the article; all authors approved the final version for publication.
Correspondence to: Giuseppe Di Lorenzo, MD, PhD, Genitourinary Cancer Section and Rare-Cancer Center, Medical Oncology Division, University Federico II, Via S. Pansini 5, 80131 Napoli, Italy. giuseppedilorenzoncol@hotmail.com
Telephone: +39-81-7463660 Fax: +39-81-7463660
Received: February 21, 2013
Revised: March 29, 2013
Accepted: April 9, 2013
Published online: May 10, 2013
Abstract

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.

Keywords: Kaposi’s sarcoma, Human herpes virus 8, Paclitaxel, Pegylated liposomal doxorubicin, Vinblastine

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.