%0 Journal Article
%T Trends in KaposiĄ¯s Sarcoma in Miami Beach from 1987 to 2007
%A Simon B. Zeichner
%A Ana L. Ruiz
%A Gabriel P. Suciu
%A Rachel Lerner Zeichner
%A Estelamari Rodriguez
%J ISRN Oncology
%D 2012
%R 10.5402/2012/642106
%X Purpose. KaposiĄ¯s sarcoma (KS) is a rare low-grade vascular tumor associated with the human herpes virus 8. By analyzing the epidemiology, staging, and treatment of KS, we hoped to improve the quality of care at our institution. Methods. Review of the Mount Sinai Medical Center tumor registry database in Miami Beach, FL, USA, identified 143 cases of KS between January 1, 1987 and December 31, 2007. Results. The majority of patients were non-Hispanic whites, non smoking males diagnosed between 1987 and 1996. Most of the patients were HIV positive, with an equal percentage diagnosed with local or distant disease. Most patients received no chemotherapy or radiation. There were no significant differences in patient survival based on sex, HIV status, or radiation received. There was a trend toward improved survival among older patients who smoked, received no chemotherapy, and had localized stage at diagnosis. Multivariate analysis revealed that non-Hispanic whites had a significant worse survival than Hispanic whites (HR = 0.55, 95% CI (0.33, 0.90), ). Patients diagnosed between 1987 and 1996 had a worse survival than those between 1997 and 2007 (HR = 0.33 (95% CI 0.19, 0.55), ). Conclusion. This large retrospective study provides further insight into KS. Ethnicity and date of diagnosis are important predictors of long-term survival. 1. Introduction First described by Hungarian dermatologist Kaposi in 1872 [1], KaposiĄ¯s sarcoma (KS) is a rare low-grade, vascular tumor associated with the human herpes virus 8 (HHV-8) [2]. KS is divided into four epidemiological subtypes: (a) classic (indolent cutaneous proliferative disease affecting older men of Mediterranean and Jewish origin [3, 4]), (b) endemic (from Africa [5, 6]), (c) solid organ transplant associated, and (d) epidemic (acquired immunodeficiency syndrome (AIDS) associated [7]). KaposiĄ¯s sarcoma is 15 times more prevalent among men than women and is most common among homosexual males. Risk factors for tumor development include human immunodeficiency virus (HIV) infection [8¨C10], high anti-HHV-8 antibody titers [10], HHV-8 viremia [11], inherited variation in immuno-modulating genes [12], immunosuppression with steroids or other immuno-suppressants [13], and absence of tobacco use [13¨C15]. KaposiĄ¯s sarcoma typically presents as cutaneous purplish, reddish-blue, or dark brown/black macules, plaques, and nodules on the lower legs and feet with or without associated extremity lymphedema. KaposiĄ¯s sarcoma lesions are heterogeneous with respect to both size and aggressiveness. Although most cases follow a
%U http://www.hindawi.com/journals/isrn.oncology/2012/642106/