Classical Kaposi's sarcoma: a survey of 163 cases observed in Bari, south Italy.

Background: Classical Kaposi's sarcoma (KS) is a sporadic disease that is particularly prevalent in Mediterranean countries.
Objective: The aim of the study was to update clinical information about this rare condition.
Methods: A survey of 163 cases observed in the period 1971-1990 in Bari, South Italy, was carried out. All records were reviewed and, when lost to follow-up for more than 6 months, patients were called back to update personal and family histories. The age at onset averaged 64 years (range 18-85). The male-to-female ratio was 3:1. No familiar occurrence was identified, and no significant association was found with other conditions (i.e. second primary malignancies and diabetes mellitus). Death from KS occurred in 16 cases, at the mean age of 71 years, an average of 5.7 years after the onset of the disease. To assess whether the different clinical patterns of the disease in its earlier stages may give any indication of its subsequent clinical course, all cases were re-classified into three groups (low-, moderate- and high-eruptivity group) on the basis of both the extent and the rate of spread of the disease before first admission; group-stratified survival function was evaluated using Kaplan-Meier's life table method.
Results: Highly significant (p < 0.0001) differences were found in survival profiles of the three study groups, also when only deaths due to KS were computed.
Conclusion: These findings provide some support to the hypothesis that three subsets of classical KS exist that have different prognoses and, consequently, need different therapeutic approaches.