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Cancer-associated myositis: a single-centre 20-year experience
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DOI：10.1007/s10067-026-08332-3.png)
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Abstract
En 中文
Malignancy identified around the onset of idiopathic inflammatory myopathy (IIM) is referred to as cancer-associated myositis (CAM), but population-specific data remain relatively limited. To describe the prevalence, clinical features, and risk factors for CAM over a 20-year period in a single tertiary centre in Greece. A retrospective analysis was conducted on 113 IIM cases treated between 2001 and 2024 in our department, which is a referral centre for rheumatic disease in Central Greece. Medical records were evaluated for demographics, clinical characteristics, autoantibody profile, and comorbidities. CAM was defined as cases of myositis complicated by the onset or recurrence of cancer within 3 years before or after the diagnosis of myositis. CAM was identified in 25 (22.1%) patients. Older age and dermatomyositis subtype were associated with CAM. Anti-TIF1γ autoantibody confers significantly higher risk (OR 6.9, p < 0.001), while anti-Jo1 lowers risk (OR 0.13, p = 0.022). Gottron’s papules and Holster sign were significantly associated with CAM. Raynaud’s phenomenon, interstitial lung disease and the non-interstitial pneumonia pattern appeared protective. Hypothyroidism was less common, while myocardial infarction was more frequent in CAM. Breast, ovarian, and lung cancers were the most common malignancies identified. In most cases, malignancy was asymptomatic (85%) and was determined upon screening. Survival was significantly lower in CAM p < 0.001 with the survival rate dropping down to 45% at 31 months vs 95.9% in non-CAM. Median survival was 21 months in CAM cases (1–79 months). CAM accounts for a substantial proportion of IIM cases. Anti-TIF1γ positivity, older age, absence of Raynaud’s phenomenon, and absence of ILD may serve as clinical flags in our cohort. Comprehensive cancer screening, including GI endoscopy, remains vital in the initial assessment and follow-up, primarily upon relapses and lack of remission.
Keywords:
Dysphagia
Malignancy
Myositis
Paraneoplastic phenomenon
Rash