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Annals of Oncology Advance Access published online on November 25, 2005
Annals of Oncology, doi:10.1093/annonc/mdj091
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© 2005 European Society for Medical Oncology
Received October 10, 2005
Accepted October 26, 2005

original article

The presentation and survival of patients with non-cutaneous AIDS-associated Kaposi's sarcoma

J. Stebbing 1, D. Mazhar 2, R. Lewis 2, C. Palmieri 2, E. Hatzimichael 2, M. Nelson 3, B. Gazzard 3, and M. Bower 2 *

1 Department of Immunology, Division of Investigative Science, Faculty of Medicine, Imperial College of Science, Technology and Medicine, UK; Department of HIV Medicine, The Chelsea and Westminster Hospital, UK; Department of Oncology, The Chelsea and Westminster Hospital, UK
2 Department of Oncology, The Chelsea and Westminster Hospital, UK
3 Department of HIV Medicine, The Chelsea and Westminster Hospital, UK

* To whom correspondence should be addressed.
M. Bower, E-mail: m.bower{at}ic.ac.uk


  Abstract

Background: Acquired immune deficiency syndrome related Kaposi's sarcoma (AIDS-KS) remains a significant cause of morbidity and mortality. We describe for the first time a proportion of patients with AIDS-KS who presented with no evidence of cutaneous disease.

Patients and methods: From our cohort of 5932 individuals infected with the human immunodeficiency virus (HIV-1) treated in the HAART era, 319 were identified with KS. Of these, 11 patients (5.4%) were diagnosed with KS without the presence of any cutaneous disease. We compared their survival, clinical, immunological and virological characteristics to other individuals with KS.

Results: There were no statistically significant differences in survival, CD4 count or HIV viral load at KS presentation. We observed that tumour-associated oedema (P = 0.046) and non-oral gastrointestinal KS (P = 0.042) were significantly more common in patients with non-cutaneous KS. Only one case of non-cutaneous KS was observed prior to the era of highly active anti-retroviral therapy (HAART).

Conclusions: Non-cutaneous KS is a recognisable condition; patients should be treated with the standard of care as their prognosis is not inferior. This is likely to reflect a strong immune response, in the era of HAART.

Keywords: HIV; AIDS; Kaposi's sarcoma; HAART; cutaneous.
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