Morales Ayana E, Benson Gabrielle, Glavan Stephanie, Giuliano Rosemary, Dickson Mark A
Department of Medicine, Weill Cornell Medicine, New York, NY, United States.
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States.
Oncologist. 2025 Mar 10;30(3). doi: 10.1093/oncolo/oyaf024.
Kaposi sarcoma (KS) is a vascular tumor caused by human herpesvirus 8, also known as Kaposi sarcoma herpesvirus. There are 4 distinct subtypes: classic, endemic, iatrogenic, and epidemic (HIV-associated). A fifth subtype is increasingly recognized: non-epidemic KS in men who have sex with men (MSM) who are HIV-negative. Our primary objective was to characterize non-epidemic KS to identify associated risk factors, presentation, treatment course, and prognosis of these patients.
This retrospective cohort included all patients evaluated at Memorial Sloan Kettering Cancer Center from 2000 to 2022 with pathologically proven KS who identified as MSM status, without diagnosis of HIV. Data were collected on demographics, comorbidities, coinfections, treatments, and outcomes.
Seventy-two patients were identified. The median age at the time of diagnosis was 58. At initial diagnosis, 44% of patients underwent observation, 51% received localized treatment and 5% received systemic treatment. In follow-up, 47% of patients had a progression of disease requiring recurrent treatment: 25% received localized treatment while 18% received chemotherapy. In follow-up, 7 patients died, with only 2 deaths attributed to KS; 10% of patients were diagnosed with a lymphoproliferative disorder.
This study is the largest yet to characterize the non-epidemic KS subtype in HIV-negative MSM. These individuals are younger, HIV-negative, MSM with a favorable prognosis. Additional research is needed to understand the potential risk associated with lymphoproliferative disorders.
卡波西肉瘤（KS）是一种由人类疱疹病毒8（也称为卡波西肉瘤疱疹病毒）引起的血管肿瘤。有4种不同的亚型：经典型、地方性、医源性和流行性（与HIV相关）。第五种亚型越来越受到认可：在HIV阴性的男男性行为者（MSM）中出现的非流行性KS。我们的主要目标是对非流行性KS进行特征描述，以确定这些患者的相关危险因素、临床表现、治疗过程和预后。
这项回顾性队列研究纳入了2000年至2022年在纪念斯隆凯特琳癌症中心接受评估的所有经病理证实为KS且确定为MSM状态、未诊断出HIV的患者。收集了有关人口统计学、合并症、合并感染、治疗和结局的数据。
共确定了72例患者。诊断时的中位年龄为58岁。在初次诊断时，44%的患者接受观察，51%接受局部治疗，5%接受全身治疗。在随访中，47%的患者疾病进展需要再次治疗：25%接受局部治疗，18%接受化疗。在随访中，7例患者死亡，其中只有2例死亡归因于KS；10%的患者被诊断出患有淋巴增殖性疾病。
这项研究是迄今为止对HIV阴性MSM中的非流行性KS亚型进行特征描述的最大规模研究。这些个体较年轻，HIV阴性，MSM，预后良好。需要进一步研究以了解与淋巴增殖性疾病相关的潜在风险。
