Upper gastrointestinal Kaposi's sarcoma in HIV-infected patients: ten years of endoscopy observation at a single Brazilian center

Rezende, Rosamar Eulira Fontes; Kahwage, Rafael Lima; Costa, Tarciana Vieira; Machado, Alcyone Artioli; Brunaldi, Mariângela Ottoboni; Kemp, Rafael; Modena, José Luiz Pimenta

doi:10.1016/j.ijid.2015.09.006

Cited by 22 publications

(28 citation statements)

References 32 publications

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“…Sometimes, these lesions can mimic more frequent benign (peptic) or malignant lesions [6] . As in other series, the most frequent morphologic type was polypoid/nodular, particularly noted in the stomach, which is the most commonly involved segment of the GI tract [6,9] .…”

Section: Discussionsupporting

confidence: 73%

“…The GI tract is the most commonly involved extracutaneous site, and GI lesions can be present even in the absence of cutaneous lesions [7][8][9][10] . GI involvement by KS is a rare endoscopic finding, still scarcely characterized in the literature [7,9,10] . The objective of this study is to characterize the clinical and endoscopic features of KS involvement of the GI tract in a single Portuguese center over the last decade.…”

Section: Introductionmentioning

confidence: 99%

“…The objective of this study is to characterize the clinical and endoscopic features of KS involvement of the GI tract in a single Portuguese center over the last decade. , use of immunosuppressive therapy, or any other underlying disease), and endoscopic data (localization, number, and endoscopic appearance of the lesions) [9] . Stage-stratified therapeutic approach and mortality (at 3 and 6 months) were also assessed.…”

Section: Introductionmentioning

confidence: 99%

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Clinical and Endoscopic Features of Gastrointestinal Kaposi Sarcoma: A Single-Center Portuguese Experience over the Last Decade

Carmo¹,

Marques²,

Bispo³

et al. 2017

GE Port J Gastroenterol

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Background: Kaposi sarcoma (KS) is an angioproliferative tumor caused by human herpesvirus 8 (HHV-8). Gastrointestinal (GI) involvement by KS is a rare endoscopic finding, scarcely characterized in the literature. Objective: To characterize clinical and endoscopic features of patients with GI KS. Methods: This is a single-center retrospective study of GI KS cases confirmed by immunohistochemistry in the last decade (2006-2015). The following variables were analyzed: demographic data; clinical data (extraintestinal involvement, symptoms, presence and stage of HIV infection, immunosuppressive therapy); endoscopic data; stage-stratified therapeutic approach; and mortality (at 3 and 6 months). Results: Thirteen patients with GI KS were identified: 77% were men, the mean age was 55 years, and 62% of them were Native Africans. In most cases (n = 10, 77%), KS was associated with HIV. A total of 90% of the HIV patients had a CD4+ count of <200/μL (C3, CDC classification), and 80% of them had KS as the initial manifestation of HIV infection. Thirty percent of the cases had other AIDS-defining illnesses, and only 20% received antiretroviral therapy. In the remaining 3 patients (23%), KS was associated with immunosuppressive therapy. Most patients (85%) had cutaneous lesions and 15% lung involvement. In most cases (85%), the lesions were diagnosed in the upper digestive tract in asymptomatic patients (7 stomach; 2 stomach and duodenum; 2 esophagus). Colonic involvement occurred in 2 patients presenting with hematochezia. Nearly half of the patients had more than 3 endoscopic lesions and the most frequent morphologic type was polypoid/nodular (62%). Treatment was based on antiretroviral therapy or reduction of immunosuppression and in 39% of the patients on administration of doxorubicin. Survival at 3 and 6 months was 46 and 39%, respectively. Conclusion: GI KS is mostly found in nontreated, stage 3, HIV patients, and particularly in men from areas where HHV-8 is endemic. Involvement of the upper digestive tract is often asymptomatic. The endoscopic appearance is variable and these patients have a poor prognosis.

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Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical and Endoscopic Features of Gastrointestinal Kaposi Sarcoma: A Single-Center Portuguese Experience over the Last Decade

Carmo¹,

Marques²,

Bispo³

et al. 2017

GE Port J Gastroenterol

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“…Similar results were described by Rezende et al in a retrospective study with patients presenting KS in stomach, of which 80% had concomitant skin lesions. 21 On the other hand, in a survey conducted in the city of Rio de Janeiro/Brazil by Corriça & Caldas, the involvement of skin and organs was lower, reaching around 54.8%. 22 …”

Section: Discussionmentioning

confidence: 95%

Clinical and laboratory characteristics, staging, and outcomes of individuals with AIDS-associated Kaposi's sarcoma at an university hospital

Lima¹,

Araújo

Teixeira

et al. 2017

An. Bras. Dermatol.

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BackgroundKaposi's sarcoma continues to be the most common human immunodeficiency virus - associated neoplasm with considerable morbidity and mortality.ObjectiveTo describe the clinical and laboratory characteristics, initial staging, and outcomes of aids patients with Kaposi's sarcoma at an university hospital of Recife, Pernambuco.MethodsThis is a descriptive study with analytic character, retrospective, of a case series between 2004 and 2014.ResultsOf the 22 patients included in the study, 20 were aged <40 years (72.7%). The majority had CD4+ T lymphocyte counts of <200 cells/mm3 (77.3%) and human immunodeficiency virus loads of <100,000 copies/mL (78.9%). Lesions were most commonly observed on the skin (90%), and internal organs were affected in 11 of the 22 patients. Only 7 (31.8%) of the 22 patients were undergoing antiretroviral therapy (ART) at the time of Kaposis sarcoma diagnosis, and the initial disease staging classification was high risk (Aids Clinical Trials Group Oncology Committee) in 19 of the 22 patients (86.4%). Regarding Kaposi's sarcoma treatment, 17 of 22 patients (77.3%) underwent systemic chemotherapy + ART and 5 were treated exclusively with ART. Eight of the 22 patients died (36.5%); of these, 87.5% had died within one year of Kaposi's sarcoma diagnosis.Limitation of the studyWithout a control group, this study cannot be used to generate hypotheses.ConclusionsDespite the association between aids and late Kaposi's sarcoma diagnosis in the study population, including an unfavorable risk at the time of staging, a lower mortality rate was observed relative to other studies; this might be related to access to a specialized health service.

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“…KS is a vascular tumor associated with HHV8 infection and, while rare in immunocompetent host, it is the most common neoplasm among HIV-infected patients 1, 2, 3…”

mentioning

confidence: 99%

Upper Gastrointestinal Kaposi's Sarcoma in an HIV-Infected Patient

Silva

Maia

Macedo

2016

GE Portuguese Journal of Gastroenterology

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Upper gastrointestinal Kaposi's sarcoma in HIV-infected patients: ten years of endoscopy observation at a single Brazilian center

Cited by 22 publications

References 32 publications

Clinical and Endoscopic Features of Gastrointestinal Kaposi Sarcoma: A Single-Center Portuguese Experience over the Last Decade

Clinical and Endoscopic Features of Gastrointestinal Kaposi Sarcoma: A Single-Center Portuguese Experience over the Last Decade

Clinical and laboratory characteristics, staging, and outcomes of individuals with AIDS-associated Kaposi's sarcoma at an university hospital

Upper Gastrointestinal Kaposi's Sarcoma in an HIV-Infected Patient

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