IMPROVED SURVIVAL FOR PATIENTS WITH AIDS-RELATED KAPOSIS-SARCOMA

Purpose: We retrospectively analyzed all patients with AIDS-related Ka posi's sarcoma (AIDS-KS) seen at one large California medical center t o delineate factors that may have contributed to a relative decline in survival. Methods: potential prognostic factors were analyzed individ ually, using the Cox proportional hazards regression model, for their association with survival. After a stepwise Cox regression procedure w as applied to those factors that showed a significant effect on surviv al, a subset of factors that best predicted survival was identified. W e then quantified the effect of the year of diagnosis on survival usin g a univariate Cox model. Next, we combined the year of diagnosis with the subset of prognostic factors previously identified into the Cox m odel to examine survival after adjustment for the prognostic factors. Survival distribution was estimated by the Kaplan-Meier method, and th e 95% confidence interval for the median survival was computed using t he modified reflected method. Results: In 688 patients, we identified four baseline variables that best predicted survival: CD4 cell number, hematocrit, number of KS lesions, and body mass index (BMI). Adjusted for these predictive factors, there was a significant improvement in survival for patients with AIDS-KS over the lost 6 years. Conclusion: Contrary to prior reports, survival has increased for patients with AI DS-KS. The apparent increase in observed mortality is most likely due to a decline in the CD4 cell number at presentation. (C) 1994 by Ameri can Society of Clinical Oncology.