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Impact of highly active antiretroviral therapy on the presenting features and outcome of patients with acquired immunodeficiency syndrome–related Kaposi sarcoma†‡§

  1. Guglielmo Nasti M.D.1,
  2. Ferdinando Martellotta M.D.1,
  3. Massimiliano Berretta M.D.1,
  4. Maurizio Mena M.D.2,
  5. Marco Fasan M.D.3,
  6. Giovanni Di Perri M.D.4,
  7. Renato Talamini Sc.D.5,
  8. Gabriella Pagano M.D.6,
  9. Maria Montroni M.D.7,
  10. Roberta Cinelli M.D.1,
  11. Emanuela Vaccher M.D.1,
  12. Antonella D'Arminio Monforte M.D.8,
  13. Umberto Tirelli M.D.1,¶,*

Article first published online: 16 OCT 2003

DOI: 10.1002/cncr.11816

Issue

Cancer

Cancer

Volume 98, Issue 11, pages 2440–2446, 1 December 2003

Additional Information

How to Cite

Nasti, G., Martellotta, F., Berretta, M., Mena, M., Fasan, M., Di Perri, G., Talamini, R., Pagano, G., Montroni, M., Cinelli, R., Vaccher, E., D'Arminio Monforte, A. and Tirelli, U. (2003), Impact of highly active antiretroviral therapy on the presenting features and outcome of patients with acquired immunodeficiency syndrome–related Kaposi sarcoma. Cancer, 98: 2440–2446. doi: 10.1002/cncr.11816

Author Information

  1. 1

    Division of Medical Oncology A, Italian National Cancer Institute, Aviano, Italy

  2. 2

    Division of Infectious Diseases, Cuggiono Hospital, Cuggiono, Italy

  3. 3

    Division of Infectious Diseases II, Luigi Sacco Hospital, Milan, Italy

  4. 4

    Division of Infectious Diseases, Borgo Trento Hospital, Verona, Italy

  5. 5

    Epidemiology Unit, Italian National Cancer Institute, Aviano, Italy

  6. 6

    Division of Infectious Diseases, San Martino Hospital, Genoa, Italy

  7. 7

    Immunology Clinic, University of Ancona, Ancona, Italy

  8. 8

    Division of Infectious Diseases, Luigi Sacco Hospital, Milan, Italy

  1. Fax: (011) 39 0434 659531

*Division of Medical Oncology A, National Cancer Institute-Centro di Riferimento Oncologico, Via Pedemontana Occidentale 12, 33081 Aviano (PN), Italy

  1. †

    Performed on behalf of the Gruppo Italiano Cooperativo AIDS & Tumori (GICAT) and the Italian Cohort of Naive Antiretroviral Patients (ICONA) study groups.

  2. ‡

    The following are members of the GICAT: Daniele Bernardi, Massimiliano Berretta, Roberta Cinelli, Giampiero di Gennaro, Mariagrazia Michieli, Isabella Milan, Maurizio Rupolo, Ornella Schioppa, Cecilia Simonelli, Michele Spina, Giuseppe Vultaggio, and Martina Zanetti (Aviano, Italy); Pierluigi Blanc (Bagno Ripoli, Italy); Giampiero Carosi and Massimo Puoti (Brescia, Italy); Giuliano Rizzardini and Claudia Zeroli (Busto Arsizio, Italy); Benedetto M. Celesia and Luciano Nigro (Catania, Italy); Ampelio Tocchetti (Como, Italy); Angelo Pan (Cremona, Italy); Francesco Mazzotta (Florence, Italy); Sante Grisorio (Foggia, Italy); Paolo Tundo (Galatina, Italy); Adriana Albini (Genoa, Italy); Marco Fasan, Giuseppe Landonio, Adriano Lazzarin, Carla Pastecchia, and Annalisa Ridolfo (Milan, Italy); Alberto Dolara (Monza, Italy); Vincenzo Montesarchio (Naples, Italy); Pietro L. Garavelli (Novara, Italy); Francesco Di Lorenzo and Salvatrice Mancuso (Palermo, Italy); Guido Chichino and Renato Maserati (Pavia, Italy); Daniela Padrini (Piacenza, Italy); Beatrice Adriani (Prato, Italy); Carla Lovigu (Sassari, Italy); Saverio Di Lorenzo (Sondalo, Italy); Ivano Dal Conte, Ezio Nigra, Filippo Lipani, and Alessandro Sinicco (Turin, Italy); Palma Delle Foglie (Trento, Italy); Alberto Vaglia (Treviso, Italy); Pierluigi Viale (Udine, Italy); and Enzo Raise (Venice, Italy).

  3. §

    The following are members of the ICONA study group: Maria Montroni, Giorgio Scalise, Alessandra Zoli, and S Di Cesare (Ancona, Italy); Umberto Tirelli and Guglielmo Nasti (Aviano, Italy); Giuseppe Pastore, Nicola Ladisa, and Giuseppe Minafra (Bari, Italy); Fredy Suter and Cesare Arici (Bergamo, Italy); Francesco Chiodo, Francesco M. Gritti, Vincenzo Colangeli, Carlo Fiorini, and Lorenzo Guerra (Bologna, Italy); Giampiero Carosi, Gian Pietro Cadeo, Francesco Castelli, Cristina Minardi, and D. Vangi (Brescia, Italy); Giuliano Rizzardini and G. Migliorino (Busto Arsizio, Italy); P.E. Manconi and Paola Piano (Cagliari, Italy); Teresa Ferraro and Alberto Scerbo (Catanzaro, Italy); Eligio Pizzigallo and Francesco Ricci (Chieti, Italy); Domenico Santoro and Luigi Pusterla (Como, Italy); Giuseppe Carnevale and Donata Galloni (Cremona, Italy); Paolo Viganà and Maurizio Mena (Cuggiono, Italy); Florio Ghinelli and Laura Sighinolfi (Ferrara, Italy); Francesco Leoncini, Francesco Mazzotta, Marco Pozzi, and Sergio Lo Caputo (Florence, Italy); Gioacchino Angarano, B. Grisorio, and Sergio Ferrara (Foggia, Italy); Piero Grima and Pietro Tundo (Galatina, Italy); Gabriella Pagano, Nicolò Piersantelli, Alessandro Alessandrini, and Rosita Piscopo (Genoa, Italy); Marcello Toti and Silvia Chigiotti (Grosseto, Italy); Francesco Soscia and Leonardo Tacconi (Latina, Italy); Angiolina Orani and Pietro Perini (Lecco, Italy); Antonio Scasso and Antonella Vincenti (Lucca, Italy); F. Chiodera and P. Castelli (Macerata, Italy); Alfredo Scalzini and Giovanni Fibbia (Mantua, Italy); Marco Moroni, Adriano Lazzarin, Antonio Cargnel, Gian Marco Vigevani, Lucia Caggese, Antonella D'Arminio Monforte, F. Tordato, Rosanna Novati, Antonio Galli, Sergio Merli, Carla Pastecchia, and Cesarina Moioli (Milan, Italy); R. Esposito and Costantino Mussini (Modena, Italy); Nicola Abrescia, Antonio Chirianni, Carolina Izzo, Marcello Piazza, Massimo De Marco, Vincenzo Montesarchio, E. Manzillo, and Salvatore Nappa (Naples, Italy); Angelo Colomba, Vincenzo Abbadessa, Vincenzo Prestileo, and Salvatrice Mancuso (Palermo, Italy); Claudio Ferrari and Paolo Pizzaferri (Parma, Italy); Gaetano Filice, Lorenzo Minoli, Roberto Bruno, and Renato Maserati (Pavia, Italy); Sergio Pauluzzi and F. Baldelli (Perugia, Italy); Enzo Petrelli and Anna Cioppi (Pesaro, Italy); Fabio Alberici and Antonio Ruggieri (Piacenza, Italy); Francesco Menichetti and Canio Martinelli (Pisa, Italy); Carlo De Stefano and Angela La Gala (Potenza, Italy); Tiziano Zauli and G. Ballardini (Ravenna, Italy); Giacomo Magnani and Alessandra Ursitti (Reggio Emilia, Italy); Marco Arlotti and P. Ortolani (Rimini, Italy); Luigi Ortona, Ferdinando Dianzani, Giuseppe Ippolito, Andrea Antinori, Giorio Antonucci, S. D'Elia, Pasquale Narciso, N. Petrosillo, Vincenzo Vullo, A. De Luca, L. Del Forno, Mauro Zaccarelli, Patrizio De Longis, M. Ciardi, G. D'Offizi, Pietro Noto, Maurizio Lichtner, Maria Rosa Capobianchi, E. Girardi, Patrizio Pezzotti, and Giovanni Rezza (Rome, Italy); M.S. Mura and M. Mannazzu (Sassari, Italy); Pietro Caramello, Alessandro Sinicco, Maria Luisa Soranzo, L. Gennero, M. Sciandra, and Bernardino Salassa (Turin, Italy); P.A. Grossi and Claudio Basilico (Varese, Italy); A. Poggio and G. Bottari (Verbania, Italy); Enzo Raise and Sandro Pasquinucci (Venice, Italy); Fausto De Lalla and G. Tositti (Vicenza, Italy); Francesco Resta and Antonio Chimienti (Taranto, Italy); and A. Cozzi Lepri (London, United Kingdom).

Publication History

  1. Issue published online: 17 NOV 2003
  2. Article first published online: 16 OCT 2003
  3. Manuscript Accepted: 19 AUG 2003
  4. Manuscript Revised: 13 AUG 2003
  5. Manuscript Received: 15 MAY 2003

Funded by

  • Associazione Italiana per la Ricerca sul Cancro
  • Istituto Superiore di Sanitá

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Keywords:

  • Kaposi sarcoma;
  • acquired immunodeficiency syndrome;
  • natural history;
  • highly active antiretroviral therapy

Abstract

BACKGROUND

The objective of the current study was to evaluate the impact of highly active antiretroviral therapy (HAART) on clinical characteristics of presentation and the natural history of Kaposi sarcoma (KS) in patients already receiving HAART at the time of KS diagnosis.

METHODS

The authors conducted a retrospective cohort study comparing epidemiologic, clinical, and outcome data for 160 patients who were naive to HAART at the time of KS diagnosis (KS-naive) with the corresponding data for 51 patients already receiving HAART at the time of KS diagnosis (KS-HAART). The analysis included all patients with a diagnosis of KS since January 1996 within two Italian cohorts of patients with human immunodeficiency virus.

RESULTS

Immunologic and virologic status at the time of KS diagnosis were significantly more favorable in the KS-HAART group than in the KS-naive group. The frequency of cutaneous involvement was similar in both groups, but cutaneous disease was more indolent among KS-HAART patients, with 1 anatomic site of involvement in 9 patients (21%) and less than 10 lesions in 26 patients (60%), compared with 16 patients (12%; P = 0.06) and 47 patients (34%; P = 0.01), respectively, in the KS-naive group. A smaller proportion of KS-HAART patients presented with visceral disease (24% vs. 39%; P = 0.06); in particular, gastrointestinal tract involvement was significantly less frequent among KS-HAART patients (14%) compared with KS-naive patients (28%; P = 0.05). Median survival was not reached in either group, and the 3-year survival rates of KS-HAART patients (64%) and KS-naive patients (78%) were not significantly different.

CONCLUSIONS

The data from the current study indicate that KS exhibits a less aggressive presentation in patients already receiving HAART compared with patients who are naive to HAART at KS diagnosis. Natural history and outcome do not appear to be influenced by the initiation of HAART before development of KS. Cancer 2003. © 2003 American Cancer Society.

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