Rescigno Pasquale, Di Trolio Rossella, Buonerba Carlo, De Fata Gaia, Federico Piera, Bosso Davide, Virtuoso Antonella, Izzo Michela, Policastro Tania, Vaccaro Luca, Cimmino Gianfranco, Perri Francesco, Matano Elide, Delfino Mario, De Placido Sabino, Palmieri Giovannella, Di Lorenzo Giuseppe
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.
World J Clin Oncol. 2013 May 10;4(2):52-7. doi: 10.5306/wjco.v4.i2.52.
To evaluate the outcomes and potential prognostic factors in patients with non-acquired immunodeficiency syndrome (AIDS)-related Kaposi's sarcoma (KS).
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.
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).
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.
评估非获得性免疫缺陷综合征（AIDS）相关的卡波西肉瘤（KS）患者的治疗结果及潜在的预后因素。
本回顾性分析纳入了经组织学证实为非AIDS相关KS且接受全身化疗的患者。在某些情况下，通过免疫组织化学评估人疱疹病毒8的状态。根据地中海KS分期系统对患者进行分期。采用向前逐步选择程序构建多变量模型。P值<0.05被认为具有统计学意义，所有检验均为双侧检验。
本分析纳入了32例患者。诊断时的平均年龄为70岁，男女比例约为2:1。84%的病例为经典型KS。所有患者均接受了包含以下药物之一的全身化疗：长春花生物碱、紫杉烷和聚乙二醇脂质体阿霉素。10例患者（31.5%）出现部分缓解，4例患者（12.4%）达到完全缓解，16例患者（50%）病情稳定。2例患者（6.2%）对全身治疗耐药。无进展生存期（PFS）的中位数为11.7个月，总生存期的中位数为28.5个月。多变量分析显示，结节性病变（与仅黄斑病变相比）与较低的PFS显著相关（风险比：3.09；95%置信区间：1.18 - 8.13，P = 0.0133）。
非AIDS相关KS似乎大多局限于皮肤，对全身治疗反应良好。我们的数据表明，结节性病变可能与接受化疗的患者较短的PFS相关。
