Laser Therapy for Cutaneous Kaposi Sarcoma: A Systematic Review and Meta-Analysis

TL;DR

Laser therapy, especially Nd:YAG, is a safe and effective treatment for cutaneous Kaposi sarcoma with minimal side effects and low recurrence rates.

Contribution

This study provides a systematic review and meta-analysis showing that laser therapy is a promising treatment for cutaneous Kaposi sarcoma.

Findings

Laser therapy, particularly Nd:YAG, is effective in treating cutaneous Kaposi sarcoma lesions with minimal side effects.

A pooled response rate of 88% was observed across six studies, indicating strong efficacy.

Recurrence rates were low, with no recurrence reported in seven out of eight studies.

Abstract

Cutaneous Kaposi sarcoma is a vascular malignancy characterized by abnormal blood vessel growth in the skin. Although many local treatment options are available, none are considered the standard of care, and some may cause long-term side effects. Laser therapy is a modern modality that selectively targets abnormal vessels while sparing most of the surrounding tissues. In this study, we systematically reviewed all available data on the use of laser treatment for cutaneous Kaposi sarcoma lesions. Laser therapy, particularly Neodymium:yttrium–aluminum–garnet laser (Nd:YAG), is generally effective in treating lesions and is well tolerated, with only mild and temporary side effects. However, recurrence after treatment is rare. These results suggest that laser therapy could provide patients with a safer option for controlling their disease, while also achieving desirable cosmetic results.

Background: Kaposi sarcoma (KS) is a human herpesvirus-8-associated vascular malignancy with four subtypes. Although several local therapies are available for cutaneous lesions, no standard treatment exists. Laser therapy is a minimally invasive treatment option; however, its efficacy and safety remain unclear. Objectives: To systematically review and analyze the available literature on the efficacy and safety of laser-based treatment protocols for cutaneous KS lesions. Methods: A comprehensive literature search was conducted up to August 2025 to identify randomized controlled trials, observational studies, and case series with ≥3 patients who received laser therapy for cutaneous KS. Data on patient and disease characteristics, laser protocols, outcomes and adverse events were extracted from the included studies. Results: Eight studies involving 79 patients with 371 treated lesions were included in this systematic review. The reported outcome rates varied greatly between different modalities, with inconsistent outcome definitions. No recurrence was reported in seven studies, whereas the condition in all cases in the eighth study recurred. Overall, laser therapy was well tolerated with minimal adverse effects, including mild atrophic scarring, transient post-inflammatory changes, and hyperpigmentation. Six studies were eligible for meta-analysis, yielding a pooled significant response rate of 88% (95% CI: 44.1–98.6%, I2 = 86.3%). Conclusions: Available data indicate that laser therapy may represent a safe and effective option for cutaneous KS, particularly Nd:YAG, which demonstrated good efficacy with low recurrence rates; however, further research is required to define its efficacy more precisely and to standardize treatment protocols.

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