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

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.

To systematically review and analyze the available literature on the efficacy and safety of laser-based treatment protocols for cutaneous KS lesions.

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.

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%).

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.