Background Patients with rheumatic diseases (RD) have underlying immune dysregulation and receive long-term immunosuppressive mediations which might negatively affect the outcome of a cancer in those patients. Conversely, autoimmune cells might help eliminate the cancer cells with a better outcome in RD patients.
Objectives This study was aimed at systematically investigating effects of RD on the long term outcome of four most common cancers in a retrospective cohort study.
Methods A total of 167 patients with RD and cancer and 501 age-, sex-, and cancer-matched controls without RD (1:3 ratio)who received their medical care at Seoul National University Hospital from 1992 to 2012 were included in this study. Survival curves were generated using the Kaplan-Meier plots and compared using log-ranks tests.
Results The mean age of patients with RD was 57.2±11.5 years old. Female was dominant (75.0%). Rheumatoid arthritis was most common with 114 (68.4%) cases, followed by dermatomyositis/polymyositis (10.8%), systemic lupus erythematosus (10.8%), systemic sclerosis (10.2%). There were 42 (25.1%) gastric, 28 (16.8%) colon, 49 (29.3%) lung, and 48 (28.7%) breast cancers. One patient had 2 cancers. There was no significant difference in 5-year (90.0 % vs. 91.2%) and 10-year survival rates (84.3% vs. 85.0%, P=0.983) between the cancer patients with RD and the controls (Figure 1). In a subgroup analysis by cancer types, 5-year (100% vs. 92.2%) and 10-year cancer survival of gastric cancer were significantly better in the RD group as compared to the control group (100%, vs. 82.8%, P=0.026), whereas those of colon, lung, and breast cancer did not differ between them.
Conclusions This study clearly demonstrates that the cancer survival was not worse in patients with rheumatic diseases despite the additional presence of underlying defective immune system and concurrent use of immunosuppressive medications.
Disclosure of Interest None Declared
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