Meta-analysis of the association of dermatomyositis and polymyositis with cancer

Abstract

SummaryBackground Although some features of dermatomyositis (DM) and polymyositis (PM) have been reported as possible prognostic indicators for cancer development, previous studies were small in size and were unable to establish a definitive relationship between neoplasms and DM and PM. Objectives To evaluate risk factors for developing malignancies in patients with DM and PM. Methods Meta-analysis of the studies reported in the literature was performed to unveil risk factors for developing cancer among patients with DM and PM. The included studies were either cohort or retrospective case-control studies with information on cancer status. Risk for malignancy was determined as the odds ratio (OR) or weighted mean difference (WMD) with a 95% confidence interval (CI), determined by fixed and random effects models. Stata 10.0 software was used to identify possible publication bias. Results Twenty studies with 380 patients and 1575 controls were included in the analysis. The factors that may increase the risk of cancer in patients with DM and PM were older age (WMD 11Á41, 95% CI 9Á84-12Á98), male sex (OR 1Á92, 95% CI 1Á49-2Á48), cutaneous necrosis (OR 5Á52, 95% CI 3Á49-8Á74) and dysphagia (OR 2Á41, 95% CI 1Á50-3Á86), whereas those that may provide protection against cancer included arthritis (OR 0Á38, 95% CI 0Á24-0Á61) and interstitial lung disease (OR 0Á32, 95% CI 0Á20-0Á51). Conclusions Our data suggest that age, sex, cutaneous necrosis, dysphagia, arthritis and lung complications may influence susceptibility to cancer in patients with DM and PM.

Management of Immune-Mediated Paraneoplastic Neurological Disorders

“…According to a recent meta-analysis, factors associated with a paraneoplastic etiology of myositis include advanced age, male gender, skin necrosis, and dysphagia [104]. Detection of anti-155/140-Abs in cases with negative classical Abs (anti-Jo-1, anti-PM-Scl, anti-U1-RNP, anti-U3-RNP, anti-Ku) is in 94 % associated with a paraneoplastic origin [105].…”

Paraneoplastik saç, tırnak, oral mukoza ve pigmentasyon değişiklikleri

“…Sarı tırnak sendromu (STS) nadir görülen, klasik triadını lenfödem, plevral efüzyon ve sarı tırnağın oluşturduğu bir tablodur. STS, idiyopatik olabilmesinin yanı sıra bazı malignitelerde paraneoplastik bir bulgu olarak da bildirilmiştir 12,13 . Yine de birçok paraneoplastik bulgu kadar güçlü bir belirteç değildir 13 .…”

“…Çoğu vakada 20 tırnak birden tutulur 2 . Mevcut malignitenin tedavisi ile STS'nda düzelme olması da paraneoplastik ilişkiyi desteklemekle birlikte 12 , her zaman tümör tedavisi ile gerileme olmayabilir 13 . Edinsel STS, malignite dışı durumlarda da görülebilir (Tablo 1).…”

Amyopathic dermatomyositis associated with an endometrial adenocarcinoma

“…This is the first report of the association of amyopathic DM with an adenocarcinoma of the uterus. Studies have consistently demonstrated a DM-associated risk of malignancy, especially in the elderly and within three years of the first DM diagnosis [1]. Patients with DM including the amyopathic sybtype in association with and as a non-metastatic effect of ovarian cancer or other solid tumors of the female reproductive tract have been described but very rarely with either a carcinoma or a sarcoma of the uterus [3,4].…”