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OP0031 Risk Factors for Malignancies Synchronous To The Onset of Systemic Sclerosis in Patients Positive for Anti- RNA Polymerase III Antibodies: A Eustar Multicentre Study
  1. M.G. Lazzaroni1,
  2. I. Cavazzana2,
  3. E. Colombo3,
  4. O. Distler4,
  5. R. Dobrota4,
  6. J. Hernandez4,
  7. R. Hesselstrand5,
  8. L. Czirjak6,
  9. C. Varju6,
  10. G. Nagy6,
  11. V. Smith7,
  12. P. Caramaschi8,
  13. V. Riccieri9,
  14. E. Hachulla10,
  15. K. Romanowska-Prochnicka11,
  16. A. Balbir-Gurman12,
  17. E. Chatelus13,
  18. A.C. Araùjo14,
  19. Y. Allanore15,
  20. P. Airò2
  1. 1Spedali Civili and University of Brescia
  2. 2Spedali Civili of Brescia, Brescia
  3. 3University of Sassari, Sassari, Italy
  4. 4University Hospital Zurich, Zurich, Switzerland
  5. 5Lund University, Lund, Sweden
  6. 6University of Pécs Medical Center, Pécs, Hungary
  7. 7Ghent University Hospital, Ghent, Belgium
  8. 8Azienda Ospedaliera Universitaria Integrata, Verona
  9. 9University Sapienza of Rome, Rome, Italy
  10. 10University Lille Nord-de-France, Lille, France
  11. 11Medical University of Warsaw and Department of Connective Tissue Diseases, Institute of Rheumatology, Warsaw, Poland
  12. 12Rambam Health Care Campus, Rapport Faculty of Medicine, Haifa, Israel
  13. 13Strasbourg University Hospital, Strasbourg, France
  14. 14Hospital de Curry Cabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal
  15. 15University Paris Descartes and Cochin Hospital, Paris, France

Abstract

Background Patients with anti-RNA polymerase III antibodies (anti-RNAP) have an increased risk of malignancies synchronous to the onset of Systemic Sclerosis (SSc). In a multicentre EUSTAR case-control study, however, only moderate odd ratio was observed (OR 3.85, 95%CI 1.3–10.9), except than for breast cancer (OR 20.2, 95%CI 1.4–355) (1). Defining clinical and demographic features characteristic of anti-RNAP+ SSc patients who suffer from simultaneous malignancy would be useful to individuate risk factors who can guide the clinicians in every-day practice to screen anti-RNAP+ SSc patients for cancer.

Objectives To individuate risk factors for malignancies synchronous to the onset of SSc in anti-RNAP+ patients.

Methods EUSTAR centers were asked to participate to this study, providing data on malignancy history of their anti-RNAP+ patients in a dedicated form.

Results Among 158 anti-RNAP+ SSc patients collected from 13 EUSTAR centers, 14 cases of malignancies synchronous to the onset of SSc were identified. When compared with the other 144 anti-RNAP+ patients, patients with synchronous malignancies had an older mean age at SSc onset (65.3 yrs (SD 10.0) vs 49.3 (SD13.3); p<0.001) and an increased proportion of diffuse cutaneous subset (96% vs 56%; p:0.008; OR: 10.5 95%CI 1.33–82.6). A trend for increased proportion of males was also observed (43% vs 21%; p:0.06). In particular, the risk of non-breast cancer synchronous with SSc was greatly higher in male than in female patients (43% vs. 0.8%; p<0.001; OR 95.2 95%CI 10.2–890).

Conclusions Anti-RNAP+ SSc patients of older age, and with diffuse cutaneous subset, are particularly at risk for malignancies synchronous to the onset of SSc. The risk of malignancies other than breast cancers is greatly increased in male patients. These risk factors may help in the screening for cancer in these patients.

  1. M.G. Lazzaroni et al. Anti-RNA Polymerase III Antibodies in Patients with Systemic Sclerosis: A Eustar Multicenter Collaborative Study. Ann Rheum Dis 2015;74:Suppl 2 88 doi:10.1136/annrheumdis-2015-eular.1728

Disclosure of Interest None declared

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