Diagnosis and treatment of Kaposi's sarcoma: European consensus-based interdisciplinary guideline (EDF/EADO/EORTC)

the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO)and the European Organisation for Research and Treatment of Cancer (EORTC)

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)117-127
Number of pages11
JournalEuropean Journal of Cancer
Volume114
DOIs
Publication statusPublished - Jun 1 2019

Fingerprint

Kaposi's Sarcoma
Guidelines
Therapeutics
Electrochemotherapy
Lymphatic Endothelium
Immune Reconstitution Inflammatory Syndrome
Xeroderma Pigmentosum
Human Herpesvirus 8
Retinoids
Sirolimus
Immunosuppressive Agents
Paclitaxel
Interferon-alpha
Histology
Appointments and Schedules
Radiotherapy
Immunohistochemistry
HIV
Transplants
Drug Therapy

Keywords

  • EADO
  • EDF
  • EORTC
  • Guideline
  • Kaposi
  • Sarcoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO)and the European Organisation for Research and Treatment of Cancer (EORTC) (2019). Diagnosis and treatment of Kaposi's sarcoma: European consensus-based interdisciplinary guideline (EDF/EADO/EORTC). European Journal of Cancer, 114, 117-127. https://doi.org/10.1016/j.ejca.2018.12.036

Diagnosis and treatment of Kaposi's sarcoma : European consensus-based interdisciplinary guideline (EDF/EADO/EORTC). / the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO)and the European Organisation for Research and Treatment of Cancer (EORTC).

In: European Journal of Cancer, Vol. 114, 01.06.2019, p. 117-127.

Research output: Contribution to journalArticle

the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO)and the European Organisation for Research and Treatment of Cancer (EORTC) 2019, 'Diagnosis and treatment of Kaposi's sarcoma: European consensus-based interdisciplinary guideline (EDF/EADO/EORTC)', European Journal of Cancer, vol. 114, pp. 117-127. https://doi.org/10.1016/j.ejca.2018.12.036
the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO)and the European Organisation for Research and Treatment of Cancer (EORTC). Diagnosis and treatment of Kaposi's sarcoma: European consensus-based interdisciplinary guideline (EDF/EADO/EORTC). European Journal of Cancer. 2019 Jun 1;114:117-127. https://doi.org/10.1016/j.ejca.2018.12.036
the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO)and the European Organisation for Research and Treatment of Cancer (EORTC). / Diagnosis and treatment of Kaposi's sarcoma : European consensus-based interdisciplinary guideline (EDF/EADO/EORTC). In: European Journal of Cancer. 2019 ; Vol. 114. pp. 117-127.
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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.",
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