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Diagnosis and treatment of Kaposi's sarcoma: European consensus-based interdisciplinary guideline (EDF/EADO/EORTC)
- Publication Year :
- 2019
- Publisher :
- Elsevier Ltd, 2019.
-
Abstract
- Kaposi's sarcoma (KS) is a multifocal neoplasm of lymphatic endothelium-derived cells infected with human herpesvirus 8. Four clinical subtypes are distinguished: the classic, the endemic, the epidemic subtype in HIV positive patients and the iatrogenic subtype. The diagnosis is primarily based on clinical features and confirmation by histology with immunohistochemistry. Cutaneous distribution and severity, mucosal, nodal and visceral involvement depend on the type of KS with in general indolent behaviour and chronic evolution in the classic subtype and the more severe forms in iatrogenic or epidemic subtypes. Management should aim at achieving disease control. For localised lesions, several local therapies have been developed without randomised trial comparisons. Radiotherapy, intralesional chemotherapies and electrochemotherapy have high response rates. Topical treatments-imiquimod or topical 9-cis-retinoid acid-can also be used. Systemic treatments are reserved for locally aggressive extensive and disseminated KS: the recommended first-line agents are pegylated liposomal doxorubicin (PLD) and paclitaxel. In CKS, PLD or low-dose interferon-alfa are the recommended first-line agents in younger patients. In AIDS-related KS, combination antiretroviral therapy is the first treatment option; specific systemic treatment is needed only in case of extensive disease and in the prevention and treatment of immune reconstitution inflammatory syndrome. In post-transplant KS, tapering down immunosuppressive therapy and switching to mammalian target of rapamycin (m-TOR) inhibitors are used. Follow-up schedules for patients with KS disease depend on aggressiveness of the disease.
- Subjects :
- 0301 basic medicine
Oncology
Male
Cancer Research
medicine.medical_specialty
Electrochemotherapy
Consensus
EADO
medicine.medical_treatment
610 Medicine & health
Disease
Kaposi
Guideline
03 medical and health sciences
0302 clinical medicine
Immune reconstitution inflammatory syndrome
Risk Factors
Internal medicine
medicine
Humans
1306 Cancer Research
Kaposi's sarcoma
Sarcoma, Kaposi
business.industry
EDF
EORTC
Sarcoma
10177 Dermatology Clinic
medicine.disease
Radiation therapy
Europe
030104 developmental biology
Lymphatic system
030220 oncology & carcinogenesis
2730 Oncology
Female
business
Settore MED/35 - MALATTIE CUTANEE E VENEREE
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....02f6f81c72a9d59f359bd1978d8d5dc1