Risk factors for malignancy in systemic sclerosis patients.
Systemic sclerosis (SSc) is an autoimmune connective tissue disease with multisystem involvement. An increased incidence of cancer in SSc patients compared with the general population has been reported in several reports. Our aims in this study were to determine the most common malignancies and to investigate the possible risk factors for the development of malignancy in patients with SSc. Three hundred forty SSc patients from 13 centers were included to the study. Data of the patients were obtained by evaluating their medical records retrospectively. A total of 340 patients with SSc were evaluated. Twenty-five of the patients had 19 different types of malignancy. Bladder cancer was the most common type of cancer with four patients and was followed by breast cancer with three patients, and cervix cancer and ovarian cancer with two patients each. Other types of cancers such as squamous cell skin cancer, adenocancer with an unknown origin, multiple myeloma, chronic myeloid leukemia, papillary thyroid cancer, larynx cancer, non-small cell lung cancer, follicular type non-Hodgkin lymphoma (NHL), endometrium cancer, colon cancer, uterus cancer, neuroendocrine tumor, glioblastoma multiforme, and soft tissue sarcoma were diagnosed in one patient each. The only cancer type that showed an association with cyclophosphamide dose was bladder carcinoma. Other malignancies did not show a correlation with age, sex, smoking, type and duration of the disease, autoantibodies, organ involvement, and dose and duration of cyclophosphamide therapy. Cancer may develop in any organ in patients with SSc. Continuous screening of the patients during a follow-up period is necessary for the early detection of the tumor development.
Department of Internal Medicine, Division of Rheumatology, Eskişehir Osmangazi University School of Medicine, Sümer Mahallesi, Atalı Sokak 4/2, 26400, Eskisehir, Turkey.
T
T
Kaşifoğlu
Department of Internal Medicine, Division of Rheumatology, Eskişehir Osmangazi University School of Medicine, Sümer Mahallesi, Atalı Sokak 4/2, 26400, Eskisehir, Turkey. suleyasar@yahoo.com.
Ş
Ş
Yaşar Bilge
Department of Internal Medicine, Division of Rheumatology, Çukurova University School of Medicine, Adana, Turkey.
F
F
Yıldız
Department of Internal Medicine, Division of Rheumatology, Marmara University School of Medicine, Istanbul, Turkey.
G
G
Özen
Department of Internal Medicine, Division of Rheumatology, Gaziantep University School of Medicine, Gaziantep, Turkey.
Y
Y
Pehlivan
Department of Internal Medicine, Division of Rheumatology, İstanbul Bilim University School of Medicine, Istanbul, Turkey.
N
N
Yılmaz
Department of Internal Medicine, Division of Rheumatology, İzmir Katip Çelebi University School of Medicine, Izmir, Turkey.
F
F
Tarhan
Department of Internal Medicine, Division of Rheumatology, Selçuk University Medical School of Medicine, Konya, Turkey.
S
S
Yılmaz
Department of Internal Medicine, Division of Rheumatology, Necmettin Erbakan University School of Medicine, Konya, Turkey.
A
A
Küçük
Department of Internal Medicine, Division of Rheumatology, Ege University School of Medicine, Izmir, Turkey.
H
H
Emmungil
Department of Internal Medicine, Division of Rheumatology, Fırat University School of Medicine, Elazığ, Turkey.
S S
SS
Koca
Department of Internal Medicine, Division of Rheumatology, Gülhane Military School of Medicine, Istanbul, Turkey.
M
M
Çınar
Department of Internal Medicine, Division of Rheumatology, Marmara University School of Medicine, Istanbul, Turkey.
H
H
Direskeneli
Department of Internal Medicine, Division of Rheumatology, Çukurova University School of Medicine, Adana, Turkey.
E
E
Erken
Department of Internal Medicine, Division of Rheumatology, İzmir Katip Çelebi University School of Medicine, Izmir, Turkey.
G
G
Can
Department of Internal Medicine, Division of Rheumatology, İzmir Katip Çelebi University School of Medicine, Izmir, Turkey.
M
M
Özmen
Department of Internal Medicine, Division of Rheumatology, Eskişehir Osmangazi University School of Medicine, Sümer Mahallesi, Atalı Sokak 4/2, 26400, Eskisehir, Turkey.
E
E
Gönüllü
Department of Internal Medicine, Division of Rheumatology, Gaziantep University School of Medicine, Gaziantep, Turkey.
B
B
Kisacik
Department of Internal Medicine, Division of Rheumatology, Ege University School of Medicine, Izmir, Turkey.
K
K
Aksu
Department of Internal Medicine, Division of Rheumatology, Hacettepe University School of Medicine, Ankara, Turkey.
O
O
Karadağ
Department of Microbiology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey.
N
N
Kasifoglu
Department of Public Health, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey.
D
D
Arslantas
Department of Biostatistic, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey.
F
F
Sahin
Department of Internal Medicine, Division of Rheumatology, Ege University School of Medicine, Izmir, Turkey.
G
G
Keser
Department of Internal Medicine, Division of Rheumatology, İstanbul Bilim University School of Medicine, Istanbul, Turkey.
S
S
Yavuz
Department of Internal Medicine, Division of Rheumatology, Dokuz Eylül University School of Medicine, Izmir, Turkey.
M
M
Birlik
Department of Internal Medicine, Division of Rheumatology, Gaziantep University School of Medicine, Gaziantep, Turkey.
A M
AM
Onat
D000328:Adult; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000145:classification* / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000150:complications* / Q000188:drug therapy; D014421:Turkey
D007166:Immunosuppressive Agents; D003520:Cyclophosphamide
Cyclophosphamide; Malignancy; Systemic sclerosis