Temporal relationship between idiopathic inflammatory myopathies and malignancies and its mortality: a nationwide popula
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ORIGINAL ARTICLE
Temporal relationship between idiopathic inflammatory myopathies and malignancies and its mortality: a nationwide population-based study Yoon-Kyoung Sung 1 & Sun-Young Jung 2 & Hyoungyoung Kim 1 & Seongmi Choi 3 & Seul Gi Im 3 & Eom Ji Cha 3 & Eun Jin Jang 4 & Dae-Hyun Yoo 1 & Soo-Kyung Cho 1 Received: 23 April 2019 / Revised: 24 August 2019 / Accepted: 11 September 2019 # International League of Associations for Rheumatology (ILAR) 2020
Abstract Objectives To examine the temporal relationship between malignancies and idiopathic inflammatory myopathies (IIMs) and its impact on mortality. Methods A retrospective cohort for IIM patients was conducted using the Korean National Health Insurance Service databases. We observed more than 5 years before and after the diagnosis of IIM (2002~2016) to identify IIM patients who developed any malignancy and classified these patients into two groups: the cancer-associated myositis (CAM) group, who developed malignancy within 3 years before or after the diagnosis of IIM and the cancer-not-associated myositis (CNAM) group, who developed malignancy beyond 3 years of IIM onset. The survival rates of the two groups were compared. Results We identified 1072 incident cases of IIM between 2007 and 2011. A total 225 patients of these patients were diagnosed with malignancy. The development of malignancy was frequent within 1 year before and after the time of IIM diagnosis. The common sites of malignancies in the CAM group differed from those in the CNAM group: the lung, hematologic malignancy, and the liver were common in both groups, but thyroid and oropharynx followed them in CAM while prostate, stomach, breast, and thyroid followed them in CNAM. CAM patient mortality was worse compared with CNAM patients (log-rank test, p < 0.01). Conclusions Among IIM patients with malignancy, common sites of malignancy were different between the CAM and CNAM groups, and patients with CAM had poor prognosis compared with CNAM patients. Key Points • The malignancies commonly occurred in incident idiopathic inflammatory myopathy (IIM) patients, especially within 1 year before and after the initial IIM diagnosis. • Patients with malignancy had poor survival compared with patients without malignancy. • Among the IIM patients with malignancy, patients who developed malignancy within 3 years of IIM diagnosis (cancer-associated myositis, or CAM, group) showed higher mortality than cancer-not-associated myositis, CNAM group. • We also found that the common types of malignancy were different between the CAM and CNAM groups.
Keywords Idiopathic inflammatory myositis . Malignancy . Mortality Yoon-Kyoung Sung and Sun-Young Jung contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10067-019-04782-0) contains supplementary material, which is available to authorized users. * Soo-Kyung Cho [email protected] 1
Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea
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