What is the prognosis of Kaposi sarcoma (KS)?

Updated: Mar 26, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Clinical classification of Kaposi sarcoma may be the best prognosticator, comparing localized nodular disease, locally aggressive disease, and generalized Kaposi sarcoma.

Cutaneous skin testing for anergy may correlate with clinical disease type and prognosis.

Prognosis appears to correlate with the CD4 count.

Localized nodular Kaposi sarcoma has the best prognosis, with few deaths directly attributable to Kaposi sarcoma.

Locally aggressive Kaposi sarcoma has an intermediate prognosis.

The authors do not disagree with an old African estimate of a 3-year survival rate of 64%. Generalized Kaposi sarcoma, the form seen most commonly in patients with KS-AIDS, has a 3-year survival rate closer to 0% without therapy.

The low level of access to antiretroviral drugs in HIV-infected patients explains the morbidity and mortality from AIDS-associated Kaposi sarcoma in much of Africa, including Togo. [33]

Seventy children with Kaposi sarcoma and HIV infection were evaluated in South African hospitals. [34] The mortality was high despite use of antiretrovirals and cytostatics, with 32 patients surviving only 4 months on average; 10 were lost to follow-up, and 28 were alive, with an average follow-up of 16 months.

Significant morbidity and mortality has been seen in those with Kaposi sarcoma IRIS. [35, 36]

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