Kaposi sarcoma
From IDWiki
Background
ACTG Staging
- Based on extent of tumour (T), immune status (I), and severity of systemic illness (S)
| Criterion | Lower Risk (0) | Higher risk (1) |
|---|---|---|
| Tumour (T) | Confined to skin and/or lymph nodes and/or minimal oral disease (non-nodular KS confined to palate) | Tumor-associated edema or ulceration; extensive oral KS; gastrointestinal KS; or KS in other non-nodal viscera |
| Immune status (I) | CD4 cell count >200/µL | CD4 cell count <200/µL |
| Systemic illness (S) | No history of OI or thrush; no "B" symptoms; and Karnofsky performance status >70 | History of OI or thrush; "B" symptoms present; Karnofsky performance status <70; or other HIV-related illness (eg, neurologic disease, lymphoma) |
Management
- Treatment goals are symptom alleviation, prevention of disease progression, and shrinkage of tumor to alleviate edema, organ compromise, and psychological stress
- Combination antiretroviral therapy is the mainstay of treatment for all patients with HIV
- Disease may worsen for 3 to 6 weeks following initiation of ART, due to immune reconstitution inflammatory syndrome
