Sarcoma - Kaposi: Stages

Approved by the Cancer.Net Editorial Board, 06/2013

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread. This is called the stage. To see other pages, use the menu.

Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body. Doctors use diagnostic tests to find out the cancer's stage, so staging may not be complete until all the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer.

For epidemic Kaposi sarcoma, there is no official staging system. However, in 1988 the AIDS Clinical Trials Group (ACTG) developed a staging system called the TIS system. The ACTG is the largest HIV clinical trials organization in the world and is funded by the National Institutes of Health.

The TIS system evaluates:

  • The size of the tumor (Tumor, T)

  • The status of the immune system, which is measured by the number of a specific type of white blood cell, called a CD4 cell, in the blood (Immune System, I)

  • The spread of the disease throughout the body or the presence of HIV/AIDS-related systemic illness (Systemic Illness, S)

Within each of the three parts of the system, there are two subgroups: good risk (0, zero) or poor risk (1, one).

The following table has been adapted from the original system, which was developed by the ACTG to illustrate the TIS system.


Good Risk (0)  

Poor Risk (1)  


(Any of the following)

(Any of the following)

Tumor (T)

Only located in the skin and/or lymph nodes and/or minimal oral disease (flat lesions confined to the palate or roof of the mouth)

Tumor-associated edema (fluid buildup) or ulceration (break in the surface of the skin) 

Extensive oral Kaposi sarcoma

Gastrointestinal Kaposi sarcoma

Kaposi sarcoma in other organs in the body

Immune system (I)

CD4 cell count is 200 or more cells per cubic millimeter

CD4 cell count is less than 200 cells per cubic millimeter

Systemic illness (S)

No systemic illness present

History of systemic illness and/or thrush

No “B” symptoms, which include unexplained fever, night sweats, greater than 10% involuntary weight loss, or diarrhea for more than 2 weeks

One or more “B” symptoms are present

A Karnofsky Performance Status score of 70 or higher (see below)

A Karnofsky performance status of less than 70

Other HIV-related illness is present; for example, neurological disease or lymphoma

Recurrent. Recurrent cancer is cancer that has come back after treatment. If there is a recurrence, the cancer may need to be staged again (called re-staging) using the system above.

Performance status

The Karnofsky Performance Status scale measures the ability of people with cancer to perform ordinary tasks. People with a score of 70 or higher can take care of themselves but are unable to carry on normal activity or active work.

100      Normal; no evidence of disease

90        Able to perform normal activity with only minor symptoms

80        Normal activity with effort, some symptoms

70        Able to care for self, but unable to do normal activities

60        Requires occasional assistance; cares for most needs

50        Requires considerable assistance

40        Disabled, requires special assistance

30        Severely disabled

20        Very sick; requires active supportive treatment

10        Dying; at the point of death

0          Dead

Information about the cancer’s stage will help the doctor recommend a specific treatment plan. The next section in this guide is Treatment Options. Or, use the menu to choose another section to continue reading this guide.