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Malignancy in dermatomyositis and polymyositis: analysis of 192 patients

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Abstract

This study aims to investigate the prevalence and predictive risk factors of malignancy in patients with polymyositis (PM) and dermatomyositis (DM). The medical records of 192 PM/DM patients followed up in a medical center between January 2000 and December 2013 were reviewed. Among the 192 patients, 33 patients (17.2 %) had associated cancer. Both PM and DM are significantly associated with cancer, although the risk of cancer appears to be somewhat higher among patients with DM (23.0 %) than among those with PM (8.9 %). Nasopharyngeal cancer (30.3 %) and breast cancer (18.2 %) comprised the most common malignant diseases associated with PM/DM. Univariate analysis showed that an older age at PM/DM onset, heliotrope rash, Gottron’s sign, dysphagia, and low creatine phosphokinase (CPK) level were associated with increased malignancy. Multivariate analysis revealed that independent predictors of malignancy in PM/DM were age >40 years at PM/DM onset (adjusted OR 3.44; 95 % CI 1.08–10.98; p = 0.037) and heliotrope rash (adjusted OR 2.96; 95 % CI 1.04–8.43; p = 0.042). During the follow-up period, 66 (34.4 %) patients died and the overall patient survival rates were 83.1 % at 1 year, 78.9 % at 2 years, 74.2 % at 5 years, and 65.5 % at 10 years. This study demonstrates a high frequency of malignancy (17.2 %) in DM/PM patients. Nasopharyngeal cancer and breast cancer were the most common cancer types in DM/PM patients in our study. Cancer screening should be offered to patients with newly diagnosed DM/PM. Moreover, all patients should be evaluated for the possibility of an underlying malignancy during treatment.

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Acknowledgments

The authors would like to thank Chang Gung Memorial Hospital for the financial support of this research.

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Authors and Affiliations

  1. Division of Rheumatology, Allergy, and Immunology, Chang-Gung Memorial Hospital and Chang Gung University, 5 Fu-Shin St., Kuei-Shan (333), Taoyuan, Taiwan

    Yao-Fan Fang, Yeong-Jian Jan Wu, Chang-Fu Kuo, Shue-Fen Luo & Kuang-Hui Yu

  2. Division of Rheumatology, Allergy, and Immunology, Keelung Branch of Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Yeong-Jian Jan Wu

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Correspondence to Kuang-Hui Yu.

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The research project was reviewed and approved by the Institutional Review Board at this institution. Written informed consent was not obtained from each patient due to its retrospective chart review nature and has been approved by our IRB.

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The authors declare no conflict of interest. All authors have contributions to all of the following: (1) the conception and design of the study, or acquisition of data, or analysis and interpretation of data; (2) drafting the article or revising it critically for important intellectual content; and (3) final approval of the version to be submitted.

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Fang, YF., Wu, YJ.J., Kuo, CF. et al. Malignancy in dermatomyositis and polymyositis: analysis of 192 patients. Clin Rheumatol 35, 1977–1984 (2016). https://doi.org/10.1007/s10067-016-3296-8

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  • DOI: https://doi.org/10.1007/s10067-016-3296-8

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