Background Retroperitoneal fibrosis (RPF) are associated with malignancies. However it is unclear what is the incidence of malignancies and whether particular malignancies are more prevalent in RPF.
Objectives The objective of this study was to examine standardized incidence ratios (SIRs) of cancers in patients with retroperitoneal fibrosis (RPF) compared with age- and sex-matched general population.
Methods Medical records of 111 patients diagnosed as having RPF by computed tomography, positron emission tomography and/or histological evaluation were reviewed. Forty one cases of cancers, which were confirmed by biopsies, were identified in 35 patients with RPF. SIRs were calculated for cancers, cancer types, and age at cancer diagnosis and stratified according to RPF-cancer intervals compared with general population in Korea.
Results The mean ± SD age at RPF diagnosis was 59.1±14.9 years, and 69.4% of the patients were male. The cancer SIR (95% confidence intervals) in patients with RPF relative to age- and sex-matched individuals in the general population was 3.18 (2.23 - 4.41) [2.65 (1.7 - 3.94) in men; 5.34 (2.76 - 9.32) in women]. The most frequent cancer was unspecified urinary organ cancers with SIR of 733.41 (238.14 – 1711.53). SIRs of multiple myeloma [27.58 (3.34 – 99.64)], renal cell cancers [9.53, (1.15 - 34.42)] and unspecified cancers [16.92, (2.05 - 61.12)] were also significantly higher than in general population. Whereas cancers were most frequently developed in the eighth decade of life, the peak SIR was observed in the fifth decade (8.41, 2.29 – 21.53). When stratified by RPF-cancer intervals, SIR was 6.85 (4.55 - 9.90) within 2 years of RPF diagnosis, while no significant increase in SIR was found out of 2 years. Malignancies (n=28) within 2 year of RPF diagnosis included unspecified urinary organ cancer (n=4), stomach cancer (n=4), lung cancer (n=4), colon cancer (n=3), renal cell cancer (n=2), pancreatic cancer (n=2), unspecified cancer (n=2), rectal cancer (n=1), gallbladder cancer (n=1), non-Hodgkin lymphoma (n=1), multiple myeloma (n=1), prostate cancer (n=1), thyroid cancer (n=1) and gastrointestinal stromal tumor (n=1). Predominant origin of these malignancies were epithelial cell types [transitional cell carcinomas (n=4), adenocarcinoma (n=16)].
Conclusions RPF was strongly associated with cancers, particularly within 2 years of RPF diagnosis. Our results indicate that cancer screening in patients with RPF should may be performed regularly up to 2 years after RPF diagnosis.
Temporal relationship between cancer and myositis identifies two distinctive subgroups of cancers: impact on cancer risk and survival in patients with myositis. Kang EH, Lee SJ et al Rheumatology (Oxford). 2016 Sep;55(9):1631–41.
Disclosure of Interest None declared