Incidence and survival of Kaposi Sarcoma patients: a retrospective analysis using the National Cancer Database 2004-2018

Abstract

Abstract Background Kaposi Sarcoma (KS) is a relatively uncommon skin and mucosal malignancy affecting immunocompromised and HIV/AIDS patients, with a poor prognosis. Due to its low incidence in the United States, national trends in epidemiology, treatment, and mortality within the last decade have not been characterized. Objectives We analyzed KS demographics, treatments, and mortality in the United States, 2004–2018. Methods Among KS cases diagnosed 2004–2018 in the National Cancer Database, we compared demographic and clinical characteristics of HIV + and HIV- patients, men and women, time periods. We used Kaplan-Meier survival analysis to evaluate changes in mortality over time and between subgroups. Results Of 10,027 KS patients, the mean age was 47.7\(\pm\)17.9 years, and 9,063 (90.4%) were males. The number of Black men (p<0.001) and Medicaid recipients (p < 0.001) increased over the study period. Overall, 1- and 2-year survival increased by 6.4% and 8.3%, respectively, between 2004–2007 and 2016–2018 (p < 0.0001). Among HIV+ patients, 1- and 2-year survival were 14.5% and 13.7% lower, respectively, than among HIV- patients (p=0.0074). Limitations of this study include the retrospective nature; the sample lacked complete information about B symptoms, treatment efficacy, and KS subtypes. Conclusions KS incidence among Blacks and Medicaid-insured patients has increased. Overall KS survival has improved, despite poor outcomes for HIV + patients.