Abstract
BACKGROUND: Classical Kaposi's sarcoma (CKS) is a rare angioproliferative disease associated with HHV-8, usually seen in the Mediterranean and Middle East regions. Knowing the subtypes, affected regions, and factors influencing prognosis is important for disease management. OBJECTIVE: To analyze the demographic characteristics, prognostic factors, treatment modalities, and survival of patients diagnosed with CKS. METHODS: Our center's records of patients diagnosed with CKS between January 2010 and December 2021 were retrospectively analyzed. Thirty-eight patients with histopathologically proven CKS were included in the study. Demographic and clinical characteristics of the patients, macroscopic, histopathologic, and immunohistochemical features of the lesions, treatments, and responses to treatment were evaluated. Kaplan-Meier survival curves were used to estimate survival outcomes, and log-rank test analyses were performed for intergroup comparisons. RESULTS: The median age at diagnosis of the patients was 71.0(39.0-93.0) years. Ten patients were female, and 28 were male. At the time of diagnosis, 63.2% of the patients had localised disease, nine patients were locally advanced, and five patients were metastatic. The tumor was most commonly localised in the lower extremity (65.8%), followed by the upper extremity. The median follow-up period was 69 (49-77.6) months. Local recurrence was detected in 24 patients during the follow-up. Median overall survival was not reached (NR) in localised disease(95% CI: 70.5-NR). In locally advanced disease, it was 31.1 months (95% CI: 13.8-63.0). In metastatic disease, it was 16.3 (95% CI: 12.6-20.0) months (p = 0.005). CONCLUSION: This study emphasizes that CKS in our centre predominantly affects older males and typically manifests with nodular, early-stage lesions at the time of diagnosis. The majority of patients exhibited localised disease with no evidence of systemic involvement, while lymphedema was a frequent accompanying condition. Ulcerative manifestations were relatively uncommon, and survival outcomes varied significantly based on disease stage, with a marked decline in overall survival for patients with metastatic disease. The findings emphasize the importance of early diagnosis and the development of tailored treatment strategies to improve patient outcomes.