Outcomes and prognostic factors of tonsillar Kaposi sarcoma in the United States SEER Database

Tonsillar Kaposi sarcoma (KS) is an extremely rare manifestation of KS, a neoplasm associated with human herpesvirus-8 and often linked to immunocompromised individuals. This study aims to analyze the outcomes and prognostic factors of tonsillar KS using data from the SEER (Surveillance, Epidemiology, and End Results) database, covering cases from 2000 to 2020. A total of 42 patients were identified, with the vast majority being male (97.6%) and a mean age of 40.1 years. Tumors were primarily localized (42.9%), and treatment modalities varied, with radiation therapy being the most common (38.1%), followed by chemotherapy (21.4%) and surgery (19.0%). Survival analysis showed that 21.4% of patients had died by the last follow-up, but the median survival time was not reached, indicating a relatively favorable prognosis. No statistically significant survival differences were observed based on treatment modality or other demographic factors, though there were trends towards worse outcomes for patients with regional disease and longer delays in treatment initiation. The study highlights the rarity of tonsillar KS, its demographic profile, and suggests a generally positive prognosis, although further research is needed to optimize treatment strategies for this rare form of KS.