Kavak Engin Eren, Ürün Yüksel
Department of Medical Oncology, Medical Faculty, Ankara University, Ankara, Turkey.
BMC Cancer. 2025 Apr 14;25(1):690. doi: 10.1186/s12885-025-14085-0.
Classical Kaposi's sarcoma (CKS) is a rare angioproliferative disease associated with HHV-8, usually seen in the Mediterranean and Middle East regions. Knowing the subtypes, affected regions, and factors influencing prognosis is important for disease management.
To analyze the demographic characteristics, prognostic factors, treatment modalities, and survival of patients diagnosed with CKS.
Our center's records of patients diagnosed with CKS between January 2010 and December 2021 were retrospectively analyzed. Thirty-eight patients with histopathologically proven CKS were included in the study. Demographic and clinical characteristics of the patients, macroscopic, histopathologic, and immunohistochemical features of the lesions, treatments, and responses to treatment were evaluated. Kaplan-Meier survival curves were used to estimate survival outcomes, and log-rank test analyses were performed for intergroup comparisons.
The median age at diagnosis of the patients was 71.0(39.0-93.0) years. Ten patients were female, and 28 were male. At the time of diagnosis, 63.2% of the patients had localised disease, nine patients were locally advanced, and five patients were metastatic. The tumor was most commonly localised in the lower extremity (65.8%), followed by the upper extremity. The median follow-up period was 69 (49-77.6) months. Local recurrence was detected in 24 patients during the follow-up. Median overall survival was not reached (NR) in localised disease(95% CI: 70.5-NR). In locally advanced disease, it was 31.1 months (95% CI: 13.8-63.0). In metastatic disease, it was 16.3 (95% CI: 12.6-20.0) months (p = 0.005).
This study emphasizes that CKS in our centre predominantly affects older males and typically manifests with nodular, early-stage lesions at the time of diagnosis. The majority of patients exhibited localised disease with no evidence of systemic involvement, while lymphedema was a frequent accompanying condition. Ulcerative manifestations were relatively uncommon, and survival outcomes varied significantly based on disease stage, with a marked decline in overall survival for patients with metastatic disease. The findings emphasize the importance of early diagnosis and the development of tailored treatment strategies to improve patient outcomes.
经典型卡波西肉瘤（CKS）是一种与HHV-8相关的罕见血管增殖性疾病，常见于地中海和中东地区。了解其亚型、受累部位以及影响预后的因素对于疾病管理至关重要。
分析诊断为CKS的患者的人口统计学特征、预后因素、治疗方式及生存情况。
回顾性分析本中心2010年1月至2021年12月期间诊断为CKS的患者记录。纳入38例经组织病理学证实为CKS的患者。评估患者的人口统计学和临床特征、病变的宏观、组织病理学和免疫组化特征、治疗及治疗反应。采用Kaplan-Meier生存曲线估计生存结局，并进行对数秩检验分析以进行组间比较。
患者诊断时的中位年龄为71.0（39.0 - 93.0）岁。10例为女性，28例为男性。诊断时，63.2%的患者为局限性疾病，9例为局部晚期，5例为转移性疾病。肿瘤最常见于下肢（65.8%），其次是上肢。中位随访期为69（49 - 77.6）个月。随访期间24例患者出现局部复发。局限性疾病患者的中位总生存期未达到（NR）（95%CI：70.5 - NR）。局部晚期疾病患者的中位总生存期为31.1个月（95%CI：13.8 - 63.0）。转移性疾病患者为16.3（95%CI：12.6 - 20.0）个月（p = 0.005）。
本研究强调，本中心的CKS主要影响老年男性，诊断时通常表现为结节状早期病变。大多数患者表现为局限性疾病，无全身受累证据，而淋巴水肿是常见伴随病症。溃疡表现相对少见，生存结局因疾病分期差异显著，转移性疾病患者的总生存期明显下降。研究结果强调了早期诊断以及制定个性化治疗策略以改善患者预后的重要性。
