Reducing relapse through maintenance steroid treatment can decrease the cancer risk in patients with IgG4‐sclerosing cholangitis: Based on a Japanese nationwide study. Issue 4 (10th January 2023)

• Record Type: Journal Article
• Authors: Kubota, Kensuke; Kamisawa, Terumi; Nakazawa, Takahiro; Tanaka, Atsushi; Naitoh, Itaru; Kurita, Yusuke; Takikawa, Hajime; Unno, Michiaki; Kawa, Shigeyuki; Masamune, Atsushi; Nakamura, Seiji; Okazaki, Kazuichi
• Other Names: Furumatsu Keisuke investigator.; Sawai Shigeaki investigator.; Goto Takuma investigator.; Okumura Toshikatsu investigator.; Suzuki Daisuke investigator.; Otsuka Masayuki investigator.; Kobori Ikuhiro investigator.; Tamano Masaya investigator.; Koizumi Mitsuhito investigator.; Hiasa Yoichi investigator.; Kawabe Naoto investigator.; Hirooka Yoshiki investigator.; Yamamoto Satoshi investigator.; Asano Yukio investigator.; Inui Kazuo investigator.; Horiguchi Akihiko investigator.; Watanabe Hiroyuki investigator.; Toya Daishu investigator.; Hatayama Katsuko investigator.; Ueki Toshiharu investigator.; Kinoshita Norikatsu investigator.; Sugimoto Mitsuru investigator.; Ohira Hiromasa investigator.; Mukai Tsuyoshi investigator.; Tomita Eiichi investigator.; Iwata Keisuke investigator.; Shimizu Shogo investigator.; Suetsugu Jun investigator.; Shimizu Masahito investigator.; Tsuji Keiji investigator.; Ishida Ryoko investigator.; Ito Masanori investigator.; Furukawa Ryutaro investigator.; Sakamoto Naoya investigator.; Araki Masahiro investigator.; Tanno Satoshi investigator.; Sakamoto Yasunari investigator.; Ito Tetsuhide investigator.; Takai Satoshi investigator.; Ikeya Shinichi investigator.; Yamada Takanori investigator.; Kudara Norihiko investigator.; Shimizu Akinori investigator.; Hanada Keiji investigator.; Ichiki Yasunori investigator.; Kitada Hideki investigator.; Hifumi Michio investigator.; Kimura Hiroyuki investigator.; Kurosaki Masayuki investigator.; Izumi Namiki investigator.; Sumi Hajime investigator.; Haruta Jun‐ichi investigator.; Hayashi Katsumi investigator.; Harada Ryo investigator.; Inoue Masafumi investigator.; Nakamura Shinichiro investigator.; Ito Tetsuya investigator.; Tomishima Ko investigator.; Isayama Hiroyuki investigator.; Oura Kyoko investigator.; Masaki Tsutomu investigator.; Shimokawahara Naoto investigator.; Tanoue Shirou investigator.; Maemura Kousei investigator.; Ido Akio investigator.; Mizushima Ichiro investigator.; Kawano Mitsuhiro investigator.; Yoshida Katsunori investigator.; Naganuma Makoto investigator.; Murata Miki investigator.; Nishio Akiyoshi investigator.; Fujita Yuji investigator.; Teratani Takuma investigator.; Matsubara Shohei investigator.; Tamai Hironao investigator.; Yoshida Yuu investigator.; Azemoto Ryousaku investigator.; Kamata Ken investigator.; Watanabe Tomohiro investigator.; Kurosu Takahiro investigator.; Koizumi Wasaburou investigator.; Fujita Jun investigator.; Seki Hideyuki investigator.; Ueda Yasuhiro investigator.; Fukumoto Takumi investigator.; Kousaki Takuhiro investigator.; Uchida Kazushige investigator.; Ochiai Toshimasa investigator.; Kawasaki Takeshi investigator.; Tanaka Motohiko investigator.; Ishida Etsuji investigator.; Notohara Kenji investigator.; Mori Hideaki investigator.; Mori Toshiyuki investigator.; Kawabata Hideaki investigator.; Miyata Masatoshi investigator.; Sakagami Junichi investigator.; Itoh Yoshito investigator.; Shiokawa Masahiro investigator.; Seno Hiroshi investigator.; Watanabe Noriko investigator.; Kataoka Hiromi investigator.; Aoki Toshinori investigator.; Fujishiro Mitsuhiro investigator.; Niihara Toru investigator.; Nishimata Hiroto investigator.; Mitoro Akira investigator.; Yoshiji Hitoshi investigator.; Yoshida Motoyuki investigator.; Ikeda Masafumi investigator.; Tomita Kengo investigator.; Hokari Ryota investigator.; Hayasaka Kenji investigator.; Amano Yuji investigator.; Shioji Kazuhiko investigator.; Hayashi Kazunao investigator.; Terai Shuji investigator.; Nakajima Michiko investigator.; Yamahana Junya investigator.; Matsumoto Ryusuke investigator.; Kikuchi Hideaki investigator.; Kanamori Akira investigator.; Kiriyama Seiki investigator.; Iwatsu Shinichi investigator.; Kato Yuji investigator.; Horiguchi Shigeru investigator.; Yagi Takahito investigator.; Okada Hiroyuki investigator.; Ohkawa Kazuyoshi investigator.; Hirao Motohiro investigator.; Hiramatsu Naoki investigator.; Oza Noriko investigator.; Imamura Haruo investigator.; Baba Takeshi investigator.; Nakano Shigeru investigator.; Shinobi Tetsuya investigator.; Ryozawa Shomei investigator.; Motoya Masayo investigator.; Nakase Hiroshi investigator.; Kinoshita Noboru investigator.; Ito Kei investigator.; Miyake Tatsuya investigator.; Kohge Naruaki investigator.; Tobita Hiroshi investigator.; Joshita Satoru investigator.; Umemura Takeji investigator.; Kawaguchi Shinya investigator.; Ohno Kazuya investigator.; Sonobe Koichi investigator.; Satoh Akihiko investigator.; Shimosegawa Tooru investigator.; Miura Fumihiko investigator.; Yagi Minami investigator.; Sano Keiji investigator.; Kin Toshifumi investigator.; Katanuma Akio investigator.; Koike Kazuhiko investigator.; Miura Shin investigator.; Kawashima Youhei investigator.; Kagawa Tatehiro investigator.; Azuma Seishin investigator.; Watanabe Mamoru investigator.; Honjyo Mitsuyoshi investigator.; Itoi Takao investigator.; Honda Akira investigator.; Kobayashi Katsumasa investigator.; Asano Toru investigator.; Mizuno Suguru investigator.; Koike Kazuhiko investigator.; Nishino Takayoshi investigator.; Taniguchi Hideaki investigator.; Tajiri Kazuto investigator.; Yasuda Ichiro investigator.; Tanaka Yoshiya investigator.; Oe Shinji investigator.; Harada Masaru investigator.; Kurata Masanao investigator.; Fukasawa Mituharu investigator.; Enomoto Nobuyuki investigator.; Kawaji Yuki investigator.; Kitano Masayuki investigator.; Nishise Yuko investigator.; Hirakawa Hidetoshi investigator.; Ishizawa Tetsuya investigator.; Ueno Yoshiyuki investigator.; Kaino Miyuki investigator.; Fujimoto Yuko investigator.; Sakaida Isao investigator.;
• Is Part Of: Journal of gastroenterology and hepatology. Volume 38:Issue 4(2023)
• Page Start: 556
• Page End: 564
• Publication Date: 2023-01-10
• Subjects: autoimmune pancreatitis -- cancer -- IgG4‐sclerosing cholangitis -- relapse; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.16066
• Languages: English
• ISSNs: 0815-9319

Abstract

Abstract: Objective: IgG4‐related sclerosing cholangitis (IgG4‐SC) is recognized as a benign steroid‐responsive disease; however, little is known about the risk of development of cancer in patients with IgG4‐SC and about how to counter this risk. Design: We conducted a retrospective review of the data of 924 patients with IgG4‐SC selected from a Japanese nationwide survey. The incidence, type of malignancy, and risk of malignancy in these patients were examined. Then, the standardized incidence ratio (SIR) of cancer in patients with IgG4‐SC was calculated. Results: Relapse was recognized in 19.7% (182/924) of patients, and cancer development was noted in 15% (139/924) of patients. Multivariate analysis identified only relapse as an independent risk factor for the development of cancer. In most of these patients with pancreato‐biliary cancer, the cancer developed within 8 years after the diagnosis of IgG4‐SC. The SIR for cancer after the diagnosis of IgG4‐SC was 12.68 (95% confidence interval [CI] 6.89–8.79). The SIRs of cancers involving the biliary system and pancreas were 27.35 and 18.43, respectively. The cumulative survival rate was significantly better in the group that received maintenance steroid treatment (MST) than in the group that did not; thus, MST influenced the prognosis of these patients. Conclusion: Among the cancers, the risk of pancreatic and biliary cancers is the highest in these patients. Because of the elevated cancer risk, surveillance after the diagnosis and management to prevent relapse are important in patients with IgG4‐SC to reduce the risk of development of cancer.