Kaposi's sarcoma (KS) continues to be a frequent neoplasm in third world AIDS patients. We carried out a prospective study to evaluate the effectiveness of liposomal doxorubicin (LD) in gastrointestinal KS patients as well as its differential clinical activity depending on the location of the lesions. The study included 15 male AIDS patients aged between 25 and 35 years (mean: 27 years) with more than 25 cutaneous lesions and extensive gastrointestinal KS. They were treated with LD, 20 mg/m(2) every 21 days, for six cycles. Eleven (73%) of the patients obtained a complete response of the gastrointestinal KS lesions and four (27%) a partial response. Regarding cutaneous lesions, only two (13%) of the patients reached a complete response, six (40%) a partial response and seven (47%) stabilized their disease. By applying Fisher's test we found a significant difference (P < 0.00035) when comparing the effectiveness of LD in gastrointestinal lesions in relation to cutaneous lesions. We conclude that LD is more effective in gastrointestinal KS and can be recommended in patients in third world countries with extensive gastrointestinal lesions.