Mediterranean Kaposi's sarcoma in the elderly. A randomized study of oral etoposide versus vinblastine

Brambilla, Lucia; Labianca, Roberto; Boneschi, Vinicio; Fossati, Silvia; Dallavalle, G.; Finzi, A. F.; Luporini, G

doi:10.1002/1097-0142(19941115)74:10<2873::aid-cncr2820741021>3.0.co;2-1

Cited by 53 publications

(34 citation statements)

References 13 publications

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“…However, we can assume that CKS was not advanced, given that there was no mention of advanced disease anywhere on the death certificate. With regard to the length of survival, though this information is not available on death certificates, if we compare the median age at diagnosis in Italy (Dal Maso et al, 2005) to the median age at death in our study, we can roughly calculate that survival is B10 years, which is consistent with previous studies (Brambilla et al, 1994;Franceschi et al, 1996). The geographical analysis showed a wide heterogeneity, though the reasons for the findings are unknown.…”

Section: Discussionsupporting

confidence: 88%

“…A few studies have also reported an association (positive or negative) with a variety of non-neoplastic diseases (Goedert et al, 2002;Guttman-Yassky et al, 2006;Anderson et al, 2008). Classic Kaposi's sarcoma is rarely considered to be an actual cause of death (Brambilla et al, 1994;Franceschi et al, 1996;Hiatt et al, 2008). However, little information is available on the causes of death among persons with CKS.…”

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confidence: 99%

“…However, little information is available on the causes of death among persons with CKS. No population-based studies have been conducted, and the available information derives from the sparse data retrieved from case series (Brambilla et al, 1994;Lospalluti et al, 1995;Franceschi et al, 1996;Hiatt et al, 2008). Furthermore, whereas the 10th revision of the International Classification of Diseases (ICD-10) has a specific code for Kaposi's sarcoma (KS), the ICD-9, which in many countries is still used, does not.…”

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Cause-specific mortality in classic Kaposi's sarcoma: a population-based study in Italy (1995–2002)

et al. 2009

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BACKGROUND: Little information is available on the causes of death among persons with classic Kaposi's sarcoma (CKS). METHODS: We conducted a population-based study in Italy to identify deceased persons with CKS and the underlying causes of death among them, by reviewing multiple-causes-of-death records. Standardised mortality ratios (SMRs) and 95% confidence intervals were calculated to compare the distribution of causes to that among the same-age general population of deceased persons. The geographical distribution was also evaluated. RESULTS: Of the 946 deaths among persons with CKS, 65.9% were attributable to non-neoplastic conditions and 21.9% to malignancies. For 12.2%, no lethal pathology was identified and CKS was considered as the underlying cause. In 90% of these cases, there was visceral/nodal involvement, therapy-related complications, or neoplastic cachexia. Among persons with CKS who died of other causes, an excess for lymphoid malignancies emerged (SMR ¼ 4.40) (chronic lymphocytic leukaemia (11.03), non-Hodgkin's lymphoma (4.22), Hodgkin's lymphoma (11.80), and multiple myeloma (2.3)), balanced by a deficit for all solid cancers (0.56), with a marked deficit for lung cancer (0.41). We found an excess for respiratory diseases (chronic obstructive pulmonary disease (1.86)) and genitourinary diseases (chronic renal failure (6.47)). There was marked geographical heterogeneity in the distribution of deaths. CONCLUSIONS: Though referring specifically to Italy, the results are informative for other countries and populations and all cases of CKS in general.

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Section: Discussionsupporting

confidence: 88%

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confidence: 99%

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Cause-specific mortality in classic Kaposi's sarcoma: a population-based study in Italy (1995–2002)

et al. 2009

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“…It is rarely recorded in Asia (Fujii et al, 1986;Jinhou et al, 1981;Yesudia, 1969) whereas it is more frequent in Europe, particularly in the Mediterranean area and among Ashkenazi Jews. In Italy the disease is widespread (Brambilla et al, 1994), although records have suggested that it is more common in the South (Bertaccini, 1959;Cerutti and Pisani, 1963;De Amicis, 1897). More recently, pooled rates for the whole of Italy before the advent of AIDS, were some three times higher than agestandardised rates reported from the USA (Biggar et al, 1984) and ten times higher than rates from England and Wales (Grulich et al, 1982).…”

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Classical Kaposi's sarcoma in north-east Sardinia: an overview from 1977 to 1991

Cottoni

Marco²,

Montesu³

1996

Br J Cancer

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Summary The incidence of classical Kaposi's sarcoma in 1977-91 was studied in north-east Sardinia. In this period, 160 new cases were observed in a defined area, of which 124 were in males. This represented a standardised incidence of the disease of 1.58/100 000 inhabitants per year (2.43 for males and 0.77 for females). This is the highest incidence of classical Kaposi's sarcoma so far recorded. The incidence increased with age, particularly after the age of 70 in males.

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“…Conversely, classic KS typically runs a chronic course, with patients surviving an average of 10-15 years before dying from unrelated causes (Tappero et al, 1993). Followup studies of patients with non-AIDS-associated KS are, however, few (Templeton and Bhana, 1975;Safai et al, 1980;Garcia et al, 1989;Biggar et al, 1994;Brambilla et al, 1994). An excess of second primary malignancies, particularly non-Hodgkin's lymphomas (NHLs), has been reported (Safai et al, 1980), but this seems to be substantially less marked in classic and African-type KS than in HIV-associated KS (Dictor and Attewell, 1988;Garcia et al, 1989;Biggar et al, 1994;Stein et al, 1994).…”

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Survival of classic Kaposi's sarcoma and risk of second cancer

Franceschi

Arniani²,

Balzi³

et al. 1996

Br J Cancer

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Summary In order to elucidate survival rates and risk of second primary cancer, we assessed 204 patients with histologically confirmed classic Kaposi's sarcoma (KS) who were identified in 11 Italian population-based cancer registries. One hundred and thirty-nine were men (median age 70 years) and 65 were women (median age 72). One, 5 and 10 year survival rates were 0.92, 0.69 and 0.46 respectively. Median survival was 9.4 years (i.e. not different from the Italian general population of the same sex and age (Tappero et al., 1993). Followup studies of patients with non-AIDS-associated KS are, however, few (Templeton and Bhana, 1975;Safai et al., 1980;Garcia et al., 1989;Biggar et al., 1994;Brambilla et al., 1994). An excess of second primary malignancies, particularly non-Hodgkin's lymphomas (NHLs), has been reported (Safai et al., 1980), but this seems to be substantially less marked in classic and African-type KS than in HIV-associated KS (Dictor and Attewell, 1988;Garcia et al., 1989;Biggar et al., 1994;Stein et al., 1994). Materials and methodsIn order to elucidate survival rates and risk of second primary cancer, we assessed a series of 204 patients with classic KS that was identified in the context of a casecontrol study on risk factors for KS onset . Eligible case subjects were aged 50 years or older and had histologically confirmed classic KS in the period 1976-91, according to 1 of 11 population-based Italian cancer registries. To exclude HIV-related KS, several checks were made, including assessment of medical records and death certificates and anonymous linkage of KS cases with the mandatory records of all AIDS cases in Italy . This led to the exclusion of 2 out of 206 initial KS patients. Occurrence of death or second primary cancer(s) was assessed using the same cancer registry data during a total of 1409 person-years of follow-up.We computed both observed Kaplan-Meier and relative survival curves (Parkin and Hakulinen, 1991). Annual expected probability of death and life expectancy for the general Italian population of the same sex and age groups were used for this purpose. Hazard ratios (HRs) of death and corresponding 95% confidence intervals (CIs) according to sex, age group and disease site(s) were determined by means of the Cox method. ResultsOf a total of 204 KS patients, 139 were men (median age 70 years, range 50-90) and 65 women (median age 72 years, range 50-93) ( (Figure 1). On account of the higher average age of the study population, relative survival rates were close to unity, i.e. 0.97 (s.e. = 0.02), 0.89 (s.e. = 0.04) and 0.83 (s.e. = 0.08).The observed survival curve in women was superimposable on the one in men (death HR= 1.08, 95% CI = 0.70-1.68) KS patients aged 65-74 years and 75 years or more showed significantly lower survival rates than those aged [50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] (death HR=3.37, and death HR=6.51, 95% CI=3.15-13.47, respectively) (data not shown). KS patients whose lesions were restricted to lower limbs had an HR of 1.02 (95% CI=...

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Mediterranean Kaposi's sarcoma in the elderly. A randomized study of oral etoposide versus vinblastine

Cited by 53 publications

References 13 publications

Cause-specific mortality in classic Kaposi's sarcoma: a population-based study in Italy (1995–2002)

Cause-specific mortality in classic Kaposi's sarcoma: a population-based study in Italy (1995–2002)

Classical Kaposi's sarcoma in north-east Sardinia: an overview from 1977 to 1991

Survival of classic Kaposi's sarcoma and risk of second cancer

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