Demographic profile, management, and survival of primary Gastrointestinal Kaposi Sarcoma: A USA Nationwide SEER-based study. (December 2022)

• Record Type: Journal Article
• Authors: Shah, Niraj James; Aloysius, Mark M.; Bhanat, Eldrin; Gupta, Shweta; Savio, John; Aswath, Ganesh; Schafer, David C.; Goyal, Hemant
• Is Part Of: Cancer epidemiology. Volume 81(2022)
• Publication Date: 2022-12
• Subjects: KS Kaposi Sarcoma -- HHV-8 Human Herpes Virus-8 -- HIV Human Immunodeficiency Virus -- GI Gastro-intestinal -- NCI National Cancer Institute -- NHAIAN Non-Hispanic American Indian/Alaska Native -- NHB Non-Hispanic Black -- NHW Non-Hispanic White -- H Hispanic -- cART combination anti-retroviral therapy -- RT Radiotherapy -- CT chemotherapy -- MSM Men who have sex with men; Primary Kaposi sarcoma -- Gastrointestinal Kaposi sarcoma -- Survival -- Ethnicity -- Socioeconomic factors -- Chemotherapy -- Radiation therapy; Cancer -- Epidemiology -- Periodicals; Cancer -- Prevention -- Periodicals; Cancer -- Diagnosis -- Periodicals; Carcinogenesis -- Periodicals; 616.994005
• DOI: 10.1016/j.canep.2022.102277
• Languages: English
• ISSNs: 1877-7821

Abstract

Abstract: Kaposi Sarcoma (KS) is a Human Herpes Virus-8 (HHV-8) associated angio-proliferative disorder commonly seen in patients with HIV. It most commonly involves the skin as classic purple lesions but occasionally involves the gastrointestinal (GI) tract. To date, published data is scarce on primary GI KS. Using a national database, this study analyzes the incidence, demographics, and survival of primary GI KS. We conducted a retrospective analysis (1975–2019) on biopsy-proven primary GI KS cases from 17 registries from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database. A total of 685 patients with GI KS were identified. Female gender, Non-Hispanic Asian or Pacific Islander (NHAPI), married marital status, and large bowel site-specific primary KS to have better overall survival. Luminal gastrointestinal KS was more frequent (84.96%) than solid organ involvement (3.07% of all cases). This study is the most extensive population-based study about the epidemiological and survival data of patients with primary GI KS, revealing GI KS to be a young male disease with best outcomes in the large bowel and anal canal KS while inferior outcomes in extraintestinal GI KS. Highlights: It is the largest study to date on the topic of Gastrointestinal Kaposi Sarcoma (KS), which is a rare and possibly underdiagnosed disease. The results of our study show that about one-third of these patients had KS in the large bowel. The survival outcome of large bowel KS was better than KS in the esophagus. The use of radiotherapy or chemotherapy did not have statistically significant survival benefits. Patients with GI KS and HIV poorly treated demonstrated poor survival.