Clinicopathological Features and Mortality in Patients With Kaposi Sarcoma and HIV: A Retrospective Analysis of a Thirty-Year Study From a Peruvian Oncologic Center

• Autores: Cuellar Ponce de Loen, LE, Meza, K, Holguín Ruíz, AM, Velarde Marca, J, Portillo-Alvarez, D, Castro, V, Sulca-Huamani, O, Intimayta-Escalante, C, Gaby-Pérez, R, Patel, A
• Formato: artículo
• Fecha de Publicación: 2022
• Institución: Instituto Nacional de Enfermedades Neoplásicas
• Repositorio: INEN-Institucional
• Lenguaje: inglés
• OAI Identifier: oai:repositorio.inen.sld.pe:20.500.14703/314
• Enlace del recurso: https: //doi.org/10.1200/GO.21.00379; https://hdl.handle.net/20.500.14703/314
• Nivel de acceso: acceso abierto
• Materia: Acquired Immunodeficiency Syndrome; Anti-Retroviral Agents; Antiretroviral Therapy, Highly Active; Humans; Peru; Retrospective Studies; Sarcoma, Kaposi; https://purl.org/pe-repo/ocde/ford#3.02.21

PURPOSEKaposi's sarcoma (KS) is a multifocal angioproliferative disease. In Peru, the implementation of the highly active antiretroviral treatment (HAART) program was in 2005, the model for treating patients with HIV-positive KS shifted to a potential cure. In this study, we aim to compare clinicopathological characteristics and prognostic factors associated with outcomes in patients with HIV-positive KS.METHODSWe developed a retrospective cohort study that includes patients with HIV/AIDS and KS seen in the Instituto Nacional de Enfermedades Neoplasicas between 1987 and 2017. Patients were divided into two groups according to the implementation of HAART in our country: the non-HAART group and those treated with HAART after 2005. Multivariate analysis for overall survival (OS) was performed with the Cox proportional hazard regression model.RESULTSThere was a greater visceral compromise and more extensive oral cavity involvement in the non-HAART group (60% 31.7%, P <.01). Regarding the immune status, there was a significant difference from the CD4 count at 1-year follow-up (73 v 335, P =.01). The CD4/CD8 rate were significant different before QT (0.23 v 0.13, P =.01) and at 1-year follow-up (0.12 v 0.32, P =.03.). The estimated 5-year OS rate was significantly lower (P =.0001) for the non-HAART group (41.7% 95% CI, 25.9 to 56.9) compared with the HAART group (79.3% 95% CI, 66.8 to 87.5). In the multivariate model for OS, full-HAART regimen and previous diagnosis of HIV/AIDS (P <.01) were significantly associated with longer survival.CONCLUSIONClinical and demographic characteristics of our patients are compatible with the literature, but we report a higher rate of gastrointestinal involvement. Furthermore, our findings provide evidence for the importance of HAART and its ability to reduce KS-related mortality.