No significant impact of available treatments on survival among patients with epidemic KS has been demonstrated. Therefore, antitumor therapy now should be considered palliative. In the early stages of the disease, systemic treatment may not be needed, whereas advanced disease requires systemic treatment with one or more agents known to have antitumor activity. A complete therapeutic response is difficult to achieve and if such response is obtained, maintenance therapy may be necessary. The overall prognosis for survival in patients with epidemic KS appears to depend on the severity of immune suppression and HIV infection rather than on the neoplastic proliferation and tumor load. This is reflected in the new staging proposals for KS. Ultimately, the ideal treatment for the AIDS patient with KS will be a combination of antiretroviral therapy to suppress further effects of HIV, biological therapy to reverse the immunologic defects, chemotherapy to control tumor development, and hematopoietic growth factors to ameliorate treatment toxicities.
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