In the US, the 5-year relative survival rates by stage for patients diagnosed with KS between 2012 and 2018 were as follows:[79]American Cancer Society. Survival rates for Kaposi sarcoma. Mar 2023 [internet publication].
https://www.cancer.org/cancer/types/kaposi-sarcoma/detection-diagnosis-staging/survival.html
All stages: 75%
Localised disease: 81%
Regional disease: 65%
Distant disease: 47%.
HIV-associated KS (formerly known as epidemic or AIDS-related KS)
The availability of antiretroviral therapy (ART) has substantially improved the prognosis of HIV-associated KS. Stage of KS at presentation is important; mortality rate is greater among those diagnosed with T1 disease than those with T0 disease at diagnosis.[51]Nasti G, Talamini R, Antinori A, et al. AIDS-related Kaposi's sarcoma: evaluation of potential new prognostic factors and assessment of the AIDS clinical trial group staging system in the HAART era - the Italian Cooperative Group on AIDS and Tumors and the Italian Cohort of Patients Naïve From Antiretrovirals. J Clin Oncol. 2003 Aug 1;21(15):2876-82.
http://www.ncbi.nlm.nih.gov/pubmed/12885804?tool=bestpractice.com
[80]De Boer C, Niyonzima N, Orem J, et al. Prognosis and delay of diagnosis among Kaposi's sarcoma patients in Uganda: a cross-sectional study. Infect Agent Cancer. 2014 May 20;9:17.
https://infectagentscancer.biomedcentral.com/articles/10.1186/1750-9378-9-17
http://www.ncbi.nlm.nih.gov/pubmed/24904686?tool=bestpractice.com
In AIDS patients not receiving ART, KS is a progressive disease with a median survival of weeks to months. Factors that portend a poor prognosis include visceral and pulmonary involvement and poor Karnofsky clinical performance.[5]Esser S, Schöfer H, Hoffmann C, et al. S1 guidelines for the Kaposi sarcoma. J Dtsch Dermatol Ges. 2022 Jun;20(6):892-904.
https://onlinelibrary.wiley.com/doi/10.1111/ddg.14788
http://www.ncbi.nlm.nih.gov/pubmed/35657085?tool=bestpractice.com
Classic (sporadic) KS
Classic KS has an indolent course with a median survival of years to decades. However, rapid disease with fatal visceral involvement may occur.
Iatrogenic (transplant-related) KS
KS associated with transplantation has a protracted but aggressive course with a median survival of months to years.[20]Mbulaiteye SM, Engels EA. Kaposi's sarcoma risk among transplant recipients in the United States (1993-2003). Int J Cancer. 2006 Dec 1;119(11):2685-91.
https://onlinelibrary.wiley.com/doi/10.1002/ijc.22233
http://www.ncbi.nlm.nih.gov/pubmed/16929513?tool=bestpractice.com
Progressive tumours will not spontaneously regress upon discontinuation of immunosuppression without additional treatment of KS.[5]Esser S, Schöfer H, Hoffmann C, et al. S1 guidelines for the Kaposi sarcoma. J Dtsch Dermatol Ges. 2022 Jun;20(6):892-904.
https://onlinelibrary.wiley.com/doi/10.1111/ddg.14788
http://www.ncbi.nlm.nih.gov/pubmed/35657085?tool=bestpractice.com
Endemic (observed in sub-Saharan Africa) KS
May have a low-malignant course or an aggressive course.[5]Esser S, Schöfer H, Hoffmann C, et al. S1 guidelines for the Kaposi sarcoma. J Dtsch Dermatol Ges. 2022 Jun;20(6):892-904.
https://onlinelibrary.wiley.com/doi/10.1111/ddg.14788
http://www.ncbi.nlm.nih.gov/pubmed/35657085?tool=bestpractice.com
Lymphadenopathic disease in the paediatric population often has a poor prognosis.[5]Esser S, Schöfer H, Hoffmann C, et al. S1 guidelines for the Kaposi sarcoma. J Dtsch Dermatol Ges. 2022 Jun;20(6):892-904.
https://onlinelibrary.wiley.com/doi/10.1111/ddg.14788
http://www.ncbi.nlm.nih.gov/pubmed/35657085?tool=bestpractice.com
[21]Cook-Mozaffari P, Newton R, Beral V, et al. The geographical distribution of Kaposi's sarcoma and of lymphomas in Africa before the AIDS epidemic. Br J Cancer. 1998 Dec;78(11):1521-8.
http://www.ncbi.nlm.nih.gov/pubmed/9836488?tool=bestpractice.com