Trends in Kaposi’s Sarcoma in Miami Beach from 1987 to 2007

Abstract

Purpose. Kaposi's sarcoma (KS) is a rare low-grade vascular tumor associated with the human herpes virus 8. By analyzing the epidemiology, staging, and treatment of KS, we hoped to improve the quality of care at our institution. Methods. Review of the Mount Sinai Medical Center tumor registry database in Miami Beach, FL, USA, identified 143 cases of KS between January 1, 1987 and December 31, 2007. Results. The majority of patients were non-Hispanic whites, non smoking males diagnosed between 1987 and 1996. Most of the patients were HIV positive, with an equal percentage diagnosed with local or distant disease. Most patients received no chemotherapy or radiation. There were no significant differences in patient survival based on sex, HIV status, or radiation received. There was a trend toward improved survival among older patients who smoked, received no chemotherapy, and had localized stage at diagnosis. Multivariate analysis revealed that non-Hispanic whites had a significant worse survival than Hispanic whites (HR = 0.55, 95% CI (0.33, 0.90), P = 0.02). Patients diagnosed between 1987 and 1996 had a worse survival than those between 1997 and 2007 (HR = 0.33 (95% CI 0.19, 0.55), P < 0.0001). Conclusion. This large retrospective study provides further insight into KS. Ethnicity and date of diagnosis are important predictors of long-term survival.

Mortality disparities among patients with HIV-associated Kaposi's sarcoma in the southern United States

“…Although this study was not designed to describe incidence or prevalence, it is one of the largest singlecenter case series of Kaposi's sarcoma in the United States in the post-ART era and demonstrates consistent annual diagnosis of new cases. Prior case series described 66 cases in 14 years in California [25], and 143 cases in 20 years in Florida [8]. This suggests that despite the overall downtrend in Kaposi's sarcoma incidence nationwide [13,26], geographical disparities within the United States still exist and there are areas in the United States where Kaposi's sarcoma is more prevalent than others.…”

“…Kaposi's sarcoma comes in multiple forms (classic, endemic, transplant-associated, and epidemic/HIV-associated), with HIV-associated Kaposi's sarcoma being the most aggressive and associated with the highest mortality rates [5]. Since the introduction of highly active antiretroviral therapy (ART) in the mid-1990s, both the incidence and mortality related to Kaposi's sarcoma have declined [3,[6][7][8]. Despite these improvements, those with HIV-associated Kaposi's sarcoma continue to have higher mortality than PWH without Kaposi's sarcoma [9].…”

Change in Pattern of Secondary Cancers After Kaposi Sarcoma in the Era of Antiretroviral Therapy

“…Kaposi sarcoma (KS), one of the 3 AIDS-defining cancers, is a tumor that is associated with immunosuppression, and its presence in people with human immunodeficiency virus (HIV) warrants a diagnosis of HIV/AIDS . Kaposi sarcoma manifests as cutaneous purplish, reddish-blue, or dark brown or black macules, plaques, and nodules on the lower extremities, which has also been found to spread to the gastrointestinal tract, oral cavity, lungs, and lymph nodes . The different forms of identified KS are as follows: (1) classic KS, found commonly in Jewish, Mediterranean, and Middle Eastern HIV-negative elderly men; (2) African KS, also known as endemic KS; (3) AIDS-associated KS, also known as epidemic KS, which is common in individuals with advanced immunodeficiency; and (4) iatrogenic KS .…”