Head and Neck Kaposi Sarcoma—An Updated Focus on Clinical and Epidemiological Characteristics: A Comprehensive Review
, Brenda Daniela Ortega-Hidalgo 1, César Esquivel-Chirinos 2, Iñigo Gaitán-Salvatella 3, Stephany Paladines-Calle 4 and Daniela Carmona-RuÃz 5Round 1
Reviewer 1 Report
Comments and Suggestions for Authors1.In addition to the oral cavity, Kaposi's sarcoma often occurs in the parotid gland, tonsils, tongue base, bone, and maxilla, and so on. Suggest changing the title to “Head and neck Kaposi Sarcoma. An updated focus on clinical and epidemiological characteristics. A comprehensive review”. 2.Adjust the inclusion criteria and supplement relevant materials for work up.
3.Suggest dividing the age of onset into several age groups.
Author Response
Review 1.
Q: In addition to the oral cavity, Kaposi's sarcoma often occurs in the parotid gland, tonsils, tongue base, bone, and maxilla, and so on. Suggest changing the title to “Head and neck Kaposi Sarcoma. An updated focus on clinical and epidemiological characteristics. A comprehensive review”.
A: The title was changed as suggested by the reviewer.
Q: Adjust the inclusion criteria and supplement relevant materials for work up.
A: The inclusion and exclusion criteria were adjusted. PP 3, Lines, 106. 111 and 112.
Reviewer 2 Report
Comments and Suggestions for AuthorsThe paper examines a clinically significant subject by offering a structured synthesis of the clinical presentation and epidemiological patterns of oral Kaposi’s sarcoma.
While the Introduction outlines the main forms of Kaposi’s sarcoma appropriately, it would benefit from a clearer positioning of the present review in relation to existing literature, particularly by specifying its added value or novel perspective.
The Results section is logically organized and effectively complemented by tables and figures; however, discrepancies in the number of studies included across different sections of the manuscript (for example, differing totals reported in separate line ranges) need to be resolved. Moreover, the substantial amount of incomplete or unreported clinical information—especially among endemic cases and non-HIV MSM populations—warrants a more critical interpretation rather than being presented solely as descriptive findings.
The Discussion reflects comprehensive knowledge of prior research, yet its length may detract from clarity. In particular, the in-depth exploration of HHV-8 molecular and virological mechanisms, although scientifically sound, goes beyond what is necessary for a clinically focused systematic review and could be streamlined to maintain thematic coherence.
Overall, the visual materials are clear and add value to the manuscript, though some tables would benefit from simplification and minor adjustments in formatting to further improve accessibility and consistency.
With the above mentioned modifications, I support the publication of this article.
Author Response
REVIEWER 2
First, we would like to thank the reviewer for taking the time to read our manuscript and for the suggestions that will undoubtedly enrich the article.
The paper examines a clinically significant subject by offering a structured synthesis of the clinical presentation and epidemiological patterns of oral Kaposi’s sarcoma.
Q: While the Introduction outlines the main forms of Kaposi’s sarcoma appropriately, it would benefit from a clearer positioning of the present review in relation to existing literature, particularly by specifying its added value or novel perspective.
A: A paragraph was added that describes the rationale for the review and how the results will contribute to a better understanding of this neoplasm. pp2, paragraph 3; lines 82 to 93
Q: The Results section is logically organized and effectively complemented by tables and figures; however, discrepancies in the number of studies included across different sections of the manuscript (for example, differing totals reported in separate line ranges) need to be resolved. Moreover, the substantial amount of incomplete or unreported clinical information—especially among endemic cases and non-HIV MSM populations—warrants a more critical interpretation rather than being presented solely as descriptive findings.
A: we apologize for not checking the consistency of the figures in the text and tables. The figures were verified and then corrected in both the text and tables to ensure consistency.
In cases where clinical information was not reported, a paragraph was added to the Discussion section providing a critical analysis. Pp 8, paragraph 2; lines 245 to 258.
Q: The Discussion reflects comprehensive knowledge of prior research, yet its length may detract from clarity. In particular, the in-depth exploration of HHV-8 molecular and virological mechanisms, although scientifically sound, goes beyond what is necessary for a clinically focused systematic review and could be streamlined to maintain thematic coherence.
A: Thank you very much for your comment and suggestion. The information on the biology of HIV-8 was reduced and focused on the clinical aspects of KS. pp. 9-10, paragraphs 4 and 1 (respectively); lines 321-339.
Q: Overall, the visual materials are clear and add value to the manuscript, though some tables would benefit from simplification and minor adjustments in formatting to further improve accessibility and consistency.
A: The tables were edited to improve their readability and clarity. Table 1, pp 5; Table 2, pp 7.
Reviewer 3 Report
Comments and Suggestions for AuthorsDear authors,
The review is interesting, focusing on a review of Kaposi sarcoma, especially in the oral cavity, with a large time of evaluation of literature data.
The paper is original and can add to the literature a complete revision on this topic.
Conclusions are consistent with the evidence and arguments presented.
No ethical problems were found
No inflammatory material is found
Suggestions
Line 33: “in 96 articles being included in the review. The 117 33 articles were categorized as follows” – please specify if the total article are 96 or 117, these sentences are confusing.
Can authors specify the limitations of the study in a more detailed paragraph?
Author Response
REVIEWER 3.
First, we would like to thank the reviewer for taking the time to read our manuscript and for the suggestions that will undoubtedly enrich the article.
The review is interesting, focusing on a review of Kaposi sarcoma, especially in the oral cavity, with a large time of evaluation of literature data.
The paper is original and can add to the literature a complete revision on this topic.
Conclusions are consistent with the evidence and arguments presented.
No ethical problems were found
No inflammatory material is found
Suggestions
Q: Line 33: “in 96 articles being included in the review. The 117 33 articles were categorized as follows” – please specify if the total article are 96 or 117, these sentences are confusing.
A: A: we apologize for not checking the consistency of the figures in the text and tables. The figures were verified and then corrected in both the text and tables to ensure consistency.
Q: Can authors specify the limitations of the study in a more detailed paragraph?
A: pp10, paragraoh 3; lines 371-377.
