Survival of patients with kaposi sarcoma at Ocean Road Cancer Institute; A retrospective study

Abstract

Background Kaposi sarcoma (KS) is a vascular endothelia tumor caused by HH8 facilitated by immune suppression either by organ transplant treatment or AIDS. KS is the most common type of all cancers in HIV-AIDS patients and second most prevalent of all cancer at ORCI. ORCI receives patients with endemic and epidemic KS; however most patients with KS are HIV positive, but the difference in characteristics between these diseases in terms of disease profile, patients’ characteristics, their prognosis and response to treatment modalities is not known leading to hindrance in provision of quality care and improving survival of the KS patients attending ORCI. Objective and Methodology The purpose of this study was to determine the overall survival and interaction of its determinants for patients with KS attending ORCI. Retrospective descriptive study, using structured questionnaire, data extracted from KS patients treated at ORCI in 2006. Descriptive, Bi-variate Analysis, Ordinal Regression, Life Tables and Kaplan Meier survival analysis as well as SPSS 16.0 and Log rants validity test were used during data analysis. Results Mean age at KS diagnosis was found to be 40 ± 12.012 years, male diagnosed with KS older than female with mean age at diagnosis being 42.60 ± 12.6 and 35.1 ± 9.7years respectively. Average duration patients wait after diagnosis before the start of treatment was found to be 30 ± 120 days. Dar es Salaam, 49.7% contributed the largest proportion of patients seen at ORCI. Male are more affected by KS with a ratio of 1.6:1 than female while radiotherapy found to be most preferred modality of treatment, 82% of all patients compared with 38.6% treated by chemotherapy. Skin was the most common mode of presentation seen on 87.3% of all patients. Median and average survival of KS patients vii were found to be 8 ± 0.613 months and 15.863 ± 1.407 months respectively. Primary organ of presentation and patient residence has shown significantly to influence survival while age, sex, treatment modality, hemoglobin level, time taken waiting for treatments found to be survival predictors, serum white cell counts, and modality of treatment or treatment compliance has not proved to influence survival. HIV still found to be major cofactor with about 90% of tested KS patients had infected with HIV. Conclusion Overall and median survival of patients with KS treated at ORCI was significantly low compared to other parts of the world; this has been contributed by factors stipulated in this study and possible differences in disease profile of patients seen at ORCI compared with other settings. Prospective studies are advised to sharpen our knowledge on this interaction as well as exerting more effort in treating KS patient early after diagnosis and joining CTC and cancer care for better outcome.