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Diagnosis and treatment of Kaposi's sarcoma: European consensus-based interdisciplinary guideline (EDF/EADO/EORTC)
C. Lebbe, C. Garbe, AJ. Stratigos, C. Harwood, K. Peris, VD. Marmol, J. Malvehy, I. Zalaudek, C. Hoeller, R. Dummer, AM. Forsea, L. Kandolf-Sekulovic, J. Olah, P. Arenberger, M. Bylaite-Bucinskiene, R. Vieira, M. Middleton, A. Levy, AM....
Jazyk angličtina Země Velká Británie
Typ dokumentu časopisecké články, multicentrická studie
- MeSH
- Kaposiho sarkom diagnóza patologie terapie MeSH
- konsensus MeSH
- lidé MeSH
- rizikové faktory MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Evropa MeSH
Kaposi's sarcoma (KS) is a multifocal neoplasm of lymphatic endothelium-derived cells infected with human herpesvirus 8. Four clinical subtypes are distinguished: the classic, the endemic, the epidemic subtype in HIV positive patients and the iatrogenic subtype. The diagnosis is primarily based on clinical features and confirmation by histology with immunohistochemistry. Cutaneous distribution and severity, mucosal, nodal and visceral involvement depend on the type of KS with in general indolent behaviour and chronic evolution in the classic subtype and the more severe forms in iatrogenic or epidemic subtypes. Management should aim at achieving disease control. For localised lesions, several local therapies have been developed without randomised trial comparisons. Radiotherapy, intralesional chemotherapies and electrochemotherapy have high response rates. Topical treatments-imiquimod or topical 9-cis-retinoid acid-can also be used. Systemic treatments are reserved for locally aggressive extensive and disseminated KS: the recommended first-line agents are pegylated liposomal doxorubicin (PLD) and paclitaxel. In CKS, PLD or low-dose interferon-alfa are the recommended first-line agents in younger patients. In AIDS-related KS, combination antiretroviral therapy is the first treatment option; specific systemic treatment is needed only in case of extensive disease and in the prevention and treatment of immune reconstitution inflammatory syndrome. In post-transplant KS, tapering down immunosuppressive therapy and switching to mammalian target of rapamycin (m-TOR) inhibitors are used. Follow-up schedules for patients with KS disease depend on aggressiveness of the disease.
Carol Davila University of Medicine and Pharmacy Bucharest Romania
Department of Dermatology and Allergology University of Szeged Hungary
Department of Dermatology Coimbra University Hospital Centre Coimbra Portugal
Department of Dermatology Faculty of Medicine Military Medical Academy Belgrade Serbia
Department of Dermatology Hospital Clinic of Barcelona IDIBAPS and CIBER de raras Spain
Department of Dermatology Medical University of Vienna Austria
Department of Medical Oncology Gustave Roussy Comprehensive Cancer Center Villejuif Paris Sud France
University Department of Dermatology Erasme Hospital Universite´ Libre de Bruxelles Brussels Belgium
University Department of Dermatology Tuebingen Germany
University Hospital Zurich Department of Dermatology Zürich Switzerland
Citace poskytuje Crossref.org
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- $a Kaposi's sarcoma (KS) is a multifocal neoplasm of lymphatic endothelium-derived cells infected with human herpesvirus 8. Four clinical subtypes are distinguished: the classic, the endemic, the epidemic subtype in HIV positive patients and the iatrogenic subtype. The diagnosis is primarily based on clinical features and confirmation by histology with immunohistochemistry. Cutaneous distribution and severity, mucosal, nodal and visceral involvement depend on the type of KS with in general indolent behaviour and chronic evolution in the classic subtype and the more severe forms in iatrogenic or epidemic subtypes. Management should aim at achieving disease control. For localised lesions, several local therapies have been developed without randomised trial comparisons. Radiotherapy, intralesional chemotherapies and electrochemotherapy have high response rates. Topical treatments-imiquimod or topical 9-cis-retinoid acid-can also be used. Systemic treatments are reserved for locally aggressive extensive and disseminated KS: the recommended first-line agents are pegylated liposomal doxorubicin (PLD) and paclitaxel. In CKS, PLD or low-dose interferon-alfa are the recommended first-line agents in younger patients. In AIDS-related KS, combination antiretroviral therapy is the first treatment option; specific systemic treatment is needed only in case of extensive disease and in the prevention and treatment of immune reconstitution inflammatory syndrome. In post-transplant KS, tapering down immunosuppressive therapy and switching to mammalian target of rapamycin (m-TOR) inhibitors are used. Follow-up schedules for patients with KS disease depend on aggressiveness of the disease.
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