Risk of incident cancer in patients with Inflammatory Bowel Disease with prior breast cancer: a multicenter cohort study.

IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Guillaume Le Cosquer, Julien Kirchgesner, Cyrielle Gilletta De Saint Joseph, Philippe Seksik, Aurélien Amiot, David Laharie, Maria Nachury, Cléa Rouillon, Vered Abitbol, Alexandre Nuzzo, Stéphane Nancey, Mathurin Fumery, Amélie Biron, Nicolas Richard, Romain Altwegg, Driffa Moussata, Benedicte Caron, Mathias Vidon, Catherine Reenaers, Mathieu Uzzan, Jean-Marie Reimund, Mélanie Serrero, Marion Simon, Alban Benezech, Félix Goutorbe, Anne-Laure Pelletier, Ludovic Caillo, Charlotte Vaysse, Florian Poullenot
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Abstract

Background and aims: Breast cancer is the most common malignancy observed in patients with inflammatory bowel diseases (IBD). The aim of our study was to evaluate incident cancer rate (recurrence or new-onset cancer) in a cohort of IBD patients with a history of breast cancer according to the subsequent IBD treatment provided.

Methods: A multicenter retrospective study included consecutive IBD patients with prior breast cancer. The inclusion date corresponded to the diagnosis of index malignancy. Follow-up lasted from cancer diagnosis until the occurrence of incident cancer.

Results: Among 207 patients included (median disease duration: 13 years [IQR 6 - 21]), first line treatment (median interval of 28 months [IQR 7 - 64]) was a conventional immunosuppressant in 19.3 % of patients, anti-TNF in 19.8 %, vedolizumab in 7.2 % and ustekinumab in 1.9 %. After a median follow-up of 71 months [IQR, 34 - 148], 42 (20%) incident cancers were observed (34 breast cancer recurrences). Adjusted incidence rates per 1000 person-years were 10.2 (95%CI 6.0- 16.4) for the untreated arm and 28.9 (95%CI 11.6-59.6) for exposed patients (p= 0.0519). There was no significant difference between treated patients and controls regarding incident-cancer free survival rates (p=0.4796). In multivariable analysis, factors associated with incident cancer were stage T4d (p=0.036), triple negative tumor (p=0.016) and follow-up of less than 71 months (p=0.005).

Conclusion: We did not find a statistically significant increase in incident breast cancer related to IBD treatment beyond the already known poor prognostic factors of breast cancer.

曾患乳腺癌的炎症性肠病患者罹患癌症的风险:一项多中心队列研究。
背景和目的:乳腺癌是炎症性肠病(IBD)患者最常见的恶性肿瘤。我们的研究旨在根据随后提供的 IBD 治疗,评估一组有乳腺癌病史的 IBD 患者的癌症发生率(复发或新发癌症):一项多中心回顾性研究纳入了曾患乳腺癌的连续 IBD 患者。纳入日期与恶性肿瘤的诊断日期一致。随访时间从癌症诊断开始,直至发生癌症:在纳入的207名患者中(中位病程:13年 [IQR 6 - 21]),19.3%的患者接受了常规免疫抑制剂一线治疗(中位间隔为28个月 [IQR 7 - 64]),19.8%接受了抗肿瘤坏死因子治疗,7.2%接受了维多珠单抗治疗,1.9%接受了乌司替尼治疗。在中位随访 71 个月[IQR,34 - 148]后,观察到 42 例(20%)癌症患者(34 例乳腺癌复发)。未经治疗组的调整后每千人年发病率为 10.2(95%CI 6.0-16.4),暴露患者的调整后每千人年发病率为 28.9(95%CI 11.6-59.6)(P= 0.0519)。在无偶发癌症生存率方面,接受治疗的患者与对照组之间没有明显差异(p=0.4796)。在多变量分析中,与癌症发生相关的因素有T4d期(p=0.036)、三阴性肿瘤(p=0.016)和随访时间少于71个月(p=0.005):结论:除了已知的乳腺癌预后不良因素外,我们并未发现与肠道疾病治疗相关的乳腺癌发病率有统计学意义的显著增加。
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来源期刊
CiteScore
16.90
自引率
4.80%
发文量
903
审稿时长
22 days
期刊介绍: Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion. As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.
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