Mucosal Kaposi sarcoma, a Rare Cancer Network study

Abstract

Kaposi's sarcoma (KS) most often affect the skin but occasionally affect the mucosa of different anatomic sites. The management of mucosal KS is seldom described in the literature. Data from 15 eligible patients with mucosal KS treated between 1994 and 2008 in five institutions within three countries of the Rare Cancer Network group were collected. The inclusion criteria were as follows: age >16 years, confirmed pathological diagnosis, mucosal stages I and II, and a minimum of 6 months' follow-up after treatment. Head and neck sites were the most common (66%). Eleven cases were HIV-positive. CD4 counts correlated with disease stage. Twelve patients had biopsy only while three patients underwent local resection. Radiotherapy (RT) was delivered whatever their CD4 status was. Median total radiation dose was 16.2 Gy (0–45) delivered in median 17 days (0–40) with four patients receiving no RT. Six patients underwent chemotherapy and received from 1 to 11 cycles of various regimens namely vinblastin, caelyx, bleomycine, or interferon, whatever their CD4 counts was. Five-year disease free survival were 81.6% and 75.0% in patients undergoing RT or not, respectively. Median survival was 66.9 months. Radiation-induced toxicity was at worse grade 1–2 and was manageable whatever patients' HIV status. This small series of mucosal KSs revealed that relatively low-dose RT is overall safe and efficient in HIV-positive and negative patients. Since there are distant relapses either in multicentric cutaneous or visceral forms in head and neck cases, the role of systemic treatments may be worth investigations in addition to RT of localized disease. Surgery may be used for symptomatic lesions, with caution given the risk of bleeding.

Head and Neck Kaposi Sarcoma: Clinicopathological Analysis of 11 Cases

“…This significant association with an HIV-infection is reflected in the very low number of HIV-negative patients who present with oral KS (only 5% of oral KS cases were in HIV-negative patients) [5,6]. Taken together, however, mucosal KS is uncommon and represents about 5% of all KS cases [10]. It is remarkable that two-thirds of mucosal KS affect head and neck sites [10].…”

“…Taken together, however, mucosal KS is uncommon and represents about 5% of all KS cases [10]. It is remarkable that two-thirds of mucosal KS affect head and neck sites [10]. An extensive literature review published in 2009 identified 251 published cases of head and neck mucosal KS and pointed to the hard palate and the oropharynx as the most frequently affected sites [6].…”

Factores asociados a la mortalidad en la población mexicana con SIDA en contraste con otras poblaciones humanas. Revisión sistemática y meta-análisis

“…En los estudios realizados, destacan los casos de sarcoma de Kaposi en Francia, en donde todos los pacientes que entraron a la terapia desarrollaron esta infección (Thariat et al, 2012). También destacan por su alta prevalencia Cuba con un estudio en donde todo el grupo de pacientes con SIDA presentó esta enfermedad (Kouri et al, 2014).…”

Role of Radiotherapy in Mucosal Kaposi Sarcoma

“…In a multicenter clinical trial on MCS, it was reported that complete control rates ranged from 60 to 93% with minimal toxicity. It was found that median survival was 66.9 months, and that 5-year disease-free survival rates were 81.6 and 75.0% in patients underwent radiotherapy or not, respectively [5].…”

“…Although control rate is high with radical surgery in small tumors, adjuvant therapy is needed in advanced stages. However, successful local control is achieved with radiotherapy in early stages [4,5]. In a multicenter clinical trial on MCS, it was reported that complete control rates ranged from 60 to 93% with minimal toxicity.…”