title: [Gynecological cancers in patients with inflammatory rheumatic diseases].
abstract: The risk of gynecological cancers in patients with inflammatory rheumatic diseases only seems to be elevated with respect to cervical cancer and mainly in patients with systemic lupus erythematosus. There is increasing evidence for an influence of the immune system on tumor control of gynecological malignancies; however, an adverse influence of immunosuppressive treatment in rheumatic patients was indicated only for the risk of cervical cancer. In contrast, biologics could not be shown to cause an increased risk of cervical cancer but data on this topic are limited. General screening recommendations exist for breast cancer and cervical cancer. Recommendations for follow-up after oncological treatment are presented. Because of limited evidence immunosuppressive and biological treatment should be applied with great restraint at least within the first 5 years after curative oncological treatment also for gynecological tumors. As far as breast cancer is concerned an even longer interval is under discussion.
authors.affiliation: Rheumatologie/klinische Immunologie, Medizinische Klinik und Poliklinik 2, Zentrum Innere Medizin, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland. schmalzing_m@ukw.de.
authors.forename: M
authors.initials: M
authors.lastname: Schmalzing
authors.affiliation: Frauenklinik und Poliklinik, Universitätsklinikum Würzburg, Würzburg, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Krockenberger
authors.affiliation: Klinik für Frauenheilkunde und Geburtshilfe, Katholisches Klinikum Mainz, Mainz, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Honig
authors.affiliation: Rheumatologie/klinische Immunologie, Medizinische Klinik und Poliklinik 2, Zentrum Innere Medizin, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland.
authors.forename: H-P
authors.initials: HP
authors.lastname: Tony
mesh_terms: D018501:Antirheumatic Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005060:Europe; D019317:Evidence-Based Medicine; D005260:Female; D005833:Genital Neoplasms, Female / Q000139:chemically induced* / Q000517:prevention & control*; D005858:Germany; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents
keywords: Breast cancer; Cervical cancer; Immunosuppression; Ovarian cancer; Systemic lupus erythematosus
references.citation: Gynecol Oncol. 2012 Oct;127(1):180-5
references.pmid: 22819787
references.citation: Ann Rheum Dis. 2013 Jan;72(1):143-4
references.pmid: 22843488
references.citation: CMAJ. 2005 May 10;172(10):1319-20
references.pmid: 15883407
references.citation: J Immunol. 2008 Jun 1;180(11):7338-48
references.pmid: 18490733
references.citation: J Clin Med. 2015 Apr 03;4(4):614-33
references.pmid: 26239350
references.citation: Ann Rheum Dis. 2015 Jul;74(7):1479-80
references.pmid: 25744102
references.citation: Lancet. 1996 Aug 3;348(9023):313-8
references.pmid: 8709693
references.citation: J Clin Rheumatol. 2010 Jun;16(4):153-7
references.pmid: 20407390
references.citation: J Clin Oncol. 2013 Mar 1;31(7):961-5
references.pmid: 23129741
references.citation: Mucosal Immunol. 2008 Sep;1(5):412-20
references.pmid: 19079205
references.citation: Expert Rev Anticancer Ther. 2012 Dec;12(12):1597-611
references.pmid: 23253225
references.citation: Ann Rheum Dis. 2015 Dec;74(12):2137-43
references.pmid: 25107559
references.citation: Springerplus. 2015 Apr 25;4:196
references.pmid: 25992308
references.citation: Arthritis Res Ther. 2008;10(2):R45
references.pmid: 18433475
references.citation: Breast. 2002 Jun;11(3):228-35
references.pmid: 14965672
references.citation: Arch Gynecol Obstet. 2013 Apr;287(4):743-7
references.pmid: 23179804
references.citation: Obstet Gynecol Clin North Am. 2013 Jun;40(2):339-57
references.pmid: 23732035
references.citation: Rheumatology (Oxford). 2011 Aug;50(8):1513-8
references.pmid: 21498553
references.citation: Cochrane Database Syst Rev. 2005 Jan 25;(1):CD001768
references.pmid: 15674884
references.citation: Crit Rev Oncol Hematol. 2012 Nov;84(2):161-80
references.pmid: 22425015
references.citation: Ann Rheum Dis. 2011 Mar;70(3):414-22
references.pmid: 21131643
references.citation: Ann Transplant. 1997;2(4):14-7
references.pmid: 9869873
references.citation: Expert Rev Anticancer Ther. 2013 Jan;13(1):29-42
references.pmid: 23259425
references.citation: Ann Rheum Dis. 2015 Jun;74(6):1087-93
references.pmid: 24685910
references.citation: Asian Pac J Cancer Prev. 2014;15(8):3403-10
references.pmid: 24870729