Presence of concurrent sarcoid-like granulomas indicates better survival in cancer patients: a retrospective cohort study
Introduction An increased risk of sarcoidosis and sarcoid-like reactions in subjects with a history of malignancy has been suggested. We assessed the incidence and clinical characteristics of cancer patients with biopsies containing sarcoid-like granulomas on cancer metastasis and patient survival....
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2020-10-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/6/4/00061-2020.full |
| _version_ | 1818595358132928512 |
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| author | Mukunthan Murthi Keiichiro Yoshioka Jeong Hee Cho Sixto Arias Elio Danna Moe Zaw Greg Holt Koichiro Tatsumi Takeshi Kawasaki Mehdi Mirsaeidi |
| author_facet | Mukunthan Murthi Keiichiro Yoshioka Jeong Hee Cho Sixto Arias Elio Danna Moe Zaw Greg Holt Koichiro Tatsumi Takeshi Kawasaki Mehdi Mirsaeidi |
| author_sort | Mukunthan Murthi |
| collection | DOAJ |
| description | Introduction
An increased risk of sarcoidosis and sarcoid-like reactions in subjects with a history of malignancy has been suggested. We assessed the incidence and clinical characteristics of cancer patients with biopsies containing sarcoid-like granulomas on cancer metastasis and patient survival.
Methods
This is a retrospective, multicentre, observational study involving endobronchial ultrasound transbronchial needle aspiration and a melanoma patient dataset at the University of Miami, USA, and a sarcoidosis patient database at Chiba University, Japan. Subjects with a confirmed diagnosis of cancer and who subsequently developed granulomas in different organs were enrolled. The study was registered at Clinicaltrials.gov (NCT03844698).
Results
133 patients met the study's criteria. The most common primary cancer sites were the skin (22.5%), breast (20.3%) and lymph node (12.8%). 24 (18%) patients developed sarcoid-like granulomas within 1 year of cancer diagnosis, 54 (40.6%) between 1 and 5 years and 49 (36.8%) after 5 years. Imaging showed possible sarcoid-like granulomas in lymph nodes in 51 cases (38.3%) and lung tissue and mediastinal lymph nodes in 73 cases (54.9%); some parenchymal reticular opacity and fibrosis was found in 5 (3.7%) and significant parenchymal fibrosis in 2 (1.5%) subjects. According to logistic regression analysis, the frequency of metastatic cancer was significantly lower in patients with sarcoid-like granulomas than in controls. Moreover, multivariate Cox proportional hazard analysis showed a significant survival advantage in those with sarcoid-like granuloma.
Conclusion
Sarcoid-like granulomas are uncommon pathology findings in cancer patients. There is a significant association between the presence of granulomas and reduced metastasis and increased survival. Further study is warranted to understand the protective mechanism involved. |
| first_indexed | 2024-12-16T11:14:44Z |
| format | Article |
| id | doaj.art-2f6a910087054510af8b13738f64c352 |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-12-16T11:14:44Z |
| publishDate | 2020-10-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-2f6a910087054510af8b13738f64c3522022-12-21T22:33:37ZengEuropean Respiratory SocietyERJ Open Research2312-05412020-10-016410.1183/23120541.00061-202000061-2020Presence of concurrent sarcoid-like granulomas indicates better survival in cancer patients: a retrospective cohort studyMukunthan Murthi0Keiichiro Yoshioka1Jeong Hee Cho2Sixto Arias3Elio Danna4Moe Zaw5Greg Holt6Koichiro Tatsumi7Takeshi Kawasaki8Mehdi Mirsaeidi9 Division of Pulmonary and Critical Care, University of Miami, Miami, FL, USA Dept of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan Dept of Pathology, University of Miami, Miami, FL, USA Division of Pulmonary and Critical Care, University of Miami, Miami, FL, USA Division of Pulmonary and Critical Care, University of Miami, Miami, FL, USA Division of Pulmonary and Critical Care, University of Miami, Miami, FL, USA Division of Pulmonary and Critical Care, University of Miami, Miami, FL, USA Dept of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan Dept of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan Division of Pulmonary and Critical Care, University of Miami, Miami, FL, USA Introduction An increased risk of sarcoidosis and sarcoid-like reactions in subjects with a history of malignancy has been suggested. We assessed the incidence and clinical characteristics of cancer patients with biopsies containing sarcoid-like granulomas on cancer metastasis and patient survival. Methods This is a retrospective, multicentre, observational study involving endobronchial ultrasound transbronchial needle aspiration and a melanoma patient dataset at the University of Miami, USA, and a sarcoidosis patient database at Chiba University, Japan. Subjects with a confirmed diagnosis of cancer and who subsequently developed granulomas in different organs were enrolled. The study was registered at Clinicaltrials.gov (NCT03844698). Results 133 patients met the study's criteria. The most common primary cancer sites were the skin (22.5%), breast (20.3%) and lymph node (12.8%). 24 (18%) patients developed sarcoid-like granulomas within 1 year of cancer diagnosis, 54 (40.6%) between 1 and 5 years and 49 (36.8%) after 5 years. Imaging showed possible sarcoid-like granulomas in lymph nodes in 51 cases (38.3%) and lung tissue and mediastinal lymph nodes in 73 cases (54.9%); some parenchymal reticular opacity and fibrosis was found in 5 (3.7%) and significant parenchymal fibrosis in 2 (1.5%) subjects. According to logistic regression analysis, the frequency of metastatic cancer was significantly lower in patients with sarcoid-like granulomas than in controls. Moreover, multivariate Cox proportional hazard analysis showed a significant survival advantage in those with sarcoid-like granuloma. Conclusion Sarcoid-like granulomas are uncommon pathology findings in cancer patients. There is a significant association between the presence of granulomas and reduced metastasis and increased survival. Further study is warranted to understand the protective mechanism involved.http://openres.ersjournals.com/content/6/4/00061-2020.full |
| spellingShingle | Mukunthan Murthi Keiichiro Yoshioka Jeong Hee Cho Sixto Arias Elio Danna Moe Zaw Greg Holt Koichiro Tatsumi Takeshi Kawasaki Mehdi Mirsaeidi Presence of concurrent sarcoid-like granulomas indicates better survival in cancer patients: a retrospective cohort study ERJ Open Research |
| title | Presence of concurrent sarcoid-like granulomas indicates better survival in cancer patients: a retrospective cohort study |
| title_full | Presence of concurrent sarcoid-like granulomas indicates better survival in cancer patients: a retrospective cohort study |
| title_fullStr | Presence of concurrent sarcoid-like granulomas indicates better survival in cancer patients: a retrospective cohort study |
| title_full_unstemmed | Presence of concurrent sarcoid-like granulomas indicates better survival in cancer patients: a retrospective cohort study |
| title_short | Presence of concurrent sarcoid-like granulomas indicates better survival in cancer patients: a retrospective cohort study |
| title_sort | presence of concurrent sarcoid like granulomas indicates better survival in cancer patients a retrospective cohort study |
| url | http://openres.ersjournals.com/content/6/4/00061-2020.full |
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