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Biphasic Temporal Relationship between Cancers and Systemic Sclerosis: A Clinical Series from Montpellier University Hospital and Review of the Literature

Cancer among patients with systemic sclerosis (SSc) would appear to be more prevalent than in the general population. Pathophysiological hypotheses are multiple, involving intertwined factors such as immune system antitumoral response, oxygen species dysregulation, and immunosuppressive treatments....

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Autores principales: Partouche, Léo, Goulabchand, Radjiv, Maria, Alexandre Thibault Jacques, Rivière, Sophie, Jorgensen, Christian, Rigau, Valérie, Bourgier, Céline, Bessis, Didier, Le Quellec, Alain, Quere, Isabelle, Morel, Jacques, Guilpain, Philippe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141543/
https://www.ncbi.nlm.nih.gov/pubmed/32245039
http://dx.doi.org/10.3390/jcm9030853
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author Partouche, Léo
Goulabchand, Radjiv
Maria, Alexandre Thibault Jacques
Rivière, Sophie
Jorgensen, Christian
Rigau, Valérie
Bourgier, Céline
Bessis, Didier
Le Quellec, Alain
Quere, Isabelle
Morel, Jacques
Guilpain, Philippe
author_facet Partouche, Léo
Goulabchand, Radjiv
Maria, Alexandre Thibault Jacques
Rivière, Sophie
Jorgensen, Christian
Rigau, Valérie
Bourgier, Céline
Bessis, Didier
Le Quellec, Alain
Quere, Isabelle
Morel, Jacques
Guilpain, Philippe
author_sort Partouche, Léo
collection PubMed
description Cancer among patients with systemic sclerosis (SSc) would appear to be more prevalent than in the general population. Pathophysiological hypotheses are multiple, involving intertwined factors such as immune system antitumoral response, oxygen species dysregulation, and immunosuppressive treatments. We aimed to identify SSc patients with cancer monitored at our center, describing their clinical and immunological characteristics, such as cancer-specific outcomes. We focused in particular on the temporal relationships between cancer onset and SSc diagnosis. A retrospective study was conducted on SSc patients from Montpellier University Hospital from 2003 to 2018. Clinical characteristics and outcomes of each SSc patient with cancer were recorded. Fifty-five patients with SSc and at least one cancer was included (median age 56 years (47–66)), with a median follow-up time of 11 years (4–15). Sixty-four metachronous malignancies were identified (12 patients had two cancers). Among them, early-onset cancer occurrences (±5 years from SSc diagnosis) included 23 cancers (39% breast cancers, 13% lung cancers, and 13% gastro-intestinal tract cancers). Twenty-two cancers occurred 10 years (±5 years) after SSc diagnosis (14% breast cancers, 23% gastrointestinal (GI) tract cancers, and 18% lung cancers). Patients without any of the two autoantibodies (anti-centromere (ACA) and anti-topoisomerase (ATA-scl70) antibodies) were more prevalent in the early-onset cancer subgroup (14 vs. 6, p = 0.02). This study brought to light two peaks of cancer occurrence in SSc patients. Early-onset cancers were associated with SSc with a specific immunological signature. Late-onset cancers might be the consequence of a subtle interplay between repeated target organ inflammation, immunosuppressant use, mesenchymal cell dysfunction and subsequent genetic alterations.
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spelling pubmed-71415432020-04-15 Biphasic Temporal Relationship between Cancers and Systemic Sclerosis: A Clinical Series from Montpellier University Hospital and Review of the Literature Partouche, Léo Goulabchand, Radjiv Maria, Alexandre Thibault Jacques Rivière, Sophie Jorgensen, Christian Rigau, Valérie Bourgier, Céline Bessis, Didier Le Quellec, Alain Quere, Isabelle Morel, Jacques Guilpain, Philippe J Clin Med Article Cancer among patients with systemic sclerosis (SSc) would appear to be more prevalent than in the general population. Pathophysiological hypotheses are multiple, involving intertwined factors such as immune system antitumoral response, oxygen species dysregulation, and immunosuppressive treatments. We aimed to identify SSc patients with cancer monitored at our center, describing their clinical and immunological characteristics, such as cancer-specific outcomes. We focused in particular on the temporal relationships between cancer onset and SSc diagnosis. A retrospective study was conducted on SSc patients from Montpellier University Hospital from 2003 to 2018. Clinical characteristics and outcomes of each SSc patient with cancer were recorded. Fifty-five patients with SSc and at least one cancer was included (median age 56 years (47–66)), with a median follow-up time of 11 years (4–15). Sixty-four metachronous malignancies were identified (12 patients had two cancers). Among them, early-onset cancer occurrences (±5 years from SSc diagnosis) included 23 cancers (39% breast cancers, 13% lung cancers, and 13% gastro-intestinal tract cancers). Twenty-two cancers occurred 10 years (±5 years) after SSc diagnosis (14% breast cancers, 23% gastrointestinal (GI) tract cancers, and 18% lung cancers). Patients without any of the two autoantibodies (anti-centromere (ACA) and anti-topoisomerase (ATA-scl70) antibodies) were more prevalent in the early-onset cancer subgroup (14 vs. 6, p = 0.02). This study brought to light two peaks of cancer occurrence in SSc patients. Early-onset cancers were associated with SSc with a specific immunological signature. Late-onset cancers might be the consequence of a subtle interplay between repeated target organ inflammation, immunosuppressant use, mesenchymal cell dysfunction and subsequent genetic alterations. MDPI 2020-03-20 /pmc/articles/PMC7141543/ /pubmed/32245039 http://dx.doi.org/10.3390/jcm9030853 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Partouche, Léo
Goulabchand, Radjiv
Maria, Alexandre Thibault Jacques
Rivière, Sophie
Jorgensen, Christian
Rigau, Valérie
Bourgier, Céline
Bessis, Didier
Le Quellec, Alain
Quere, Isabelle
Morel, Jacques
Guilpain, Philippe
Biphasic Temporal Relationship between Cancers and Systemic Sclerosis: A Clinical Series from Montpellier University Hospital and Review of the Literature
title Biphasic Temporal Relationship between Cancers and Systemic Sclerosis: A Clinical Series from Montpellier University Hospital and Review of the Literature
title_full Biphasic Temporal Relationship between Cancers and Systemic Sclerosis: A Clinical Series from Montpellier University Hospital and Review of the Literature
title_fullStr Biphasic Temporal Relationship between Cancers and Systemic Sclerosis: A Clinical Series from Montpellier University Hospital and Review of the Literature
title_full_unstemmed Biphasic Temporal Relationship between Cancers and Systemic Sclerosis: A Clinical Series from Montpellier University Hospital and Review of the Literature
title_short Biphasic Temporal Relationship between Cancers and Systemic Sclerosis: A Clinical Series from Montpellier University Hospital and Review of the Literature
title_sort biphasic temporal relationship between cancers and systemic sclerosis: a clinical series from montpellier university hospital and review of the literature
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141543/
https://www.ncbi.nlm.nih.gov/pubmed/32245039
http://dx.doi.org/10.3390/jcm9030853
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