Katarzyna Krzyzanowska-Mittermayer1, Anders F Mattsson2, Dominique Maiter3, Ulla Feldt-Rasmussen4, Cecilia Camacho-Hübner5, Anton Luger6, Roger Abs7. 1. Rudolfstiftung Hospital, 1st Medical Department, Vienna, Austria. 2. Pfizer Endocrine Care, Sollentuna, Sweden. 3. UCL St Luc Hospital, Department of Endocrinology and Nutrition, Brussels, Belgium. 4. Copenhagen University, Rigshospitalet, Department of Endocrinology, Copenhagen, Denmark. 5. Endocrine Care, Pfizer Inc., New York, New York. 6. Division of Endocrinology and Metabolism, Department of Medicine III, Medical University and General Hospital of Vienna, Vienna, Austria. 7. Antwerp Centre for Endocrinology, Antwerp, Belgium.
Abstract
Context: Data on the association between growth hormone (GH) replacement in patients with GH deficiency (GHD) after malignancies and new neoplasms show conflicting results. Objective: To clarify the incidence of new malignant neoplasm in childhood-onset (CO) and adult-onset (AO) adult cancer survivors (CSs). Design: Retrospective comparison of CO-CS and AO-CS with CO idiopathic GHD (IGHD) and AO nonfunctioning pituitary adenoma (NFPA) patients and with the general population [standardized incidence ratio (SIR)]. Setting: Data from the Pfizer International Metabolic Database study (KIMS). Patients: CO-CS [n = 349; 50.4% females; mean baseline (MBL) IGF-I standard deviation score (SDS), -2.4], IGHD (n = 619; 35.7% females; MBL IGF-I SDS, -3.4), AO-CS (n = 174; 42.5% females; MBL IGF-I SDS, -1.4), and NFPA (n = 2449; 38.1% females; MBL IGF-I SDS, -1.0). Main Outcome Measures: SIRs of malignant neoplasms. Results: After a median follow-up of 5.9 years (2192 patient-years), 15 CO-CS (4.3%) had developed 16 new neoplasms. The SIR was 10.4 [95% confidence interval (CI), 5.9 to 16.9] and 6.5 (95% CI, 3.0 to 12.4) after exclusion of seven patients with skin cancers. In IGHD, three malignant neoplasms (0.5%) were observed after a median follow-up of 5.4 years (3908 patient-years; SIR, 0.47; 95% CI, 0.09 to 1.37). New malignant neoplasms occurred in three AO-CS (1.7%; SIR, 1.1; 95% CI, 0.2 to 3.2) and 146 NFPA patients (153 cases, 6.0%; SIR, 1.1; 95% CI, 0.9 to 1.2) after a median follow-up of 4.9 (1024 patient-years) and 5.6 years (15,215 patient-years). Conclusions: The risk of second malignant neoplasms was increased in CO-CS but not in AO-CS, which illustrates the need to closely follow patients on GH replacement because of a prior malignancy.
Context: Data on the association between growth hormone (GH) replacement in patients with GH deficiency (GHD) after malignancies and new neoplasms show conflicting results. Objective: To clarify the incidence of new malignant neoplasm in childhood-onset (CO) and adult-onset (AO) adult cancer survivors (CSs). Design: Retrospective comparison of CO-CS and AO-CS with CO idiopathic GHD (IGHD) and AO nonfunctioning pituitary adenoma (NFPA) patients and with the general population [standardized incidence ratio (SIR)]. Setting: Data from the Pfizer International Metabolic Database study (KIMS). Patients: CO-CS [n = 349; 50.4% females; mean baseline (MBL) IGF-I standard deviation score (SDS), -2.4], IGHD (n = 619; 35.7% females; MBLIGF-I SDS, -3.4), AO-CS (n = 174; 42.5% females; MBLIGF-I SDS, -1.4), and NFPA (n = 2449; 38.1% females; MBLIGF-I SDS, -1.0). Main Outcome Measures: SIRs of malignant neoplasms. Results: After a median follow-up of 5.9 years (2192 patient-years), 15 CO-CS (4.3%) had developed 16 new neoplasms. The SIR was 10.4 [95% confidence interval (CI), 5.9 to 16.9] and 6.5 (95% CI, 3.0 to 12.4) after exclusion of seven patients with skin cancers. In IGHD, three malignant neoplasms (0.5%) were observed after a median follow-up of 5.4 years (3908 patient-years; SIR, 0.47; 95% CI, 0.09 to 1.37). New malignant neoplasms occurred in three AO-CS (1.7%; SIR, 1.1; 95% CI, 0.2 to 3.2) and 146 NFPA patients (153 cases, 6.0%; SIR, 1.1; 95% CI, 0.9 to 1.2) after a median follow-up of 4.9 (1024 patient-years) and 5.6 years (15,215 patient-years). Conclusions: The risk of second malignant neoplasms was increased in CO-CS but not in AO-CS, which illustrates the need to closely follow patients on GH replacement because of a prior malignancy.
Authors: M Arosio; G Arnaldi; V Gasco; C Giavoli; E Puxeddu; R Vettor; M R Ambrosio; P Gallinari; H Zouater; P Fedeli; D Ferone Journal: J Endocrinol Invest Date: 2020-06-07 Impact factor: 4.256
Authors: Gudmundur Johannsson; Philippe Touraine; Ulla Feldt-Rasmussen; Antonio Pico; Greisa Vila; Anders F Mattsson; Martin Carlsson; Márta Korbonits; André P van Beek; Michael P Wajnrajch; Roy Gomez; Kevin C J Yuen Journal: J Clin Endocrinol Metab Date: 2022-06-16 Impact factor: 6.134
Authors: Margaret C S Boguszewski; Adriane A Cardoso-Demartini; Cesar Luiz Boguszewski; Wassim Chemaitilly; Claire E Higham; Gudmundur Johannsson; Kevin C J Yuen Journal: Pituitary Date: 2021-07-25 Impact factor: 4.107