Malignancies And Their Effects On Disease Course In Patients With Systemic Sclerosis

INTRODUCTION: Systemic sclerosis (SSc) is an inflammatory disease. It is well known that systemic inflammatory diseases have increased malignancy risk. Malignancy prevalence has been reported previously as 3.6-10.7% in SSc. Standardized incidence ratio (SIR) are calculated for lung cancer (4.9), skin cancer (4.2), hepatocellular carcinoma (3.3), hematological malignancies (2.3), esophageal cancer (15.9) and oropharyngeal carcinoma (9.6). Thus, the aim of study was documenting the prevalence of malignancies and their potential effect on disease course in patients with SSc with 10 years follow-up.
METHODS: SSc patients from two territory hospitals diagnosed between 2010 and 2020 were include in the study. Demographical, clinical and laboratory features were recorded. Cancer types and their effect on the features of SS were analyzed with suitable statistical methods.
RESULTS: 5 (3.4%) of 149 SSc patients (137 females and 12 males) had cancer diagnosis and their mean age was 54±6.4 years. All of 5 were females and the mean age of cancer diagnosis was 50±6.6 years. Two of them had breast cancer, one had ovary cancer, one had soft tissue sarcoma and the last one had basal cell carcinoma. Time to cancer diagnosis form SSc diagnosis was 6.6±5.5 (min-max: 2-14) years. Two of them was died at follow-up period. 3 of SSc with concomitant cancer were diffuse cutaneous SSc and 2 ones were limited cutaneous SSc subtype. Only one of the had received cyclophosphamide treatment. Dysphagia and gastroesophageal reflux disease (GERD) were prevalent in patients with cancer.
DISCUSSION AND CONCLUSION: This study shows that 3.4% of SSc patients have cancer risk. Dysphagia and other GERD symptoms are more prevalent in patients with concomitant cancer than in without ones. Dysphagia and other GERD symptoms may be candidate surrogate marker for malignancy in patients with SSc.