Malignancy and Mortality in Idiopathic Inflammatory Myositis: A Retrospective Single-Center Cohort Study
Methods: In this retrospective cohort study, all patients diagnosed with IIM and followed at Pamukkale University Faculty of Medicine between 2010 and 2025 were analyzed. Mortality rates, malignancy prevalence, and potential demographic and clinical determinants were assessed. Multivariable logistic regression analyses were performed, and results were reported as odds ratios with 95% confidence intervals. A two-sided P-value <0.05 was considered statistically significant.
Results: A total of 66 patients were included, nearly three-quarters of whom were female. Concomitant malignancy was identified in 8 (12.1%) patients, and 10 (15.2%) patients died during the follow-up period. Mortality was substantially higher among patients with malignancy compared with those without cancer (50.0% vs. 10.3%). When survivors were compared with deceased patients, the latter exhibited a significantly greater comorbidity burden and a higher prevalence of malignancy. The comorbidity burden did not reach statistical significance in multivariable analyses. Kaplan–Meier survival analysis demonstrated significantly reduced overall survival in patients with concomitant malignancy compared with those without malignancy (log-rank P=0.014).
Conclusions: The prevalence of malignancy in this cohort was consistent with previously published data, supporting the external validity of our findings. Mortality was markedly higher among patients with cancer, and malignancy was disproportionately represented among deceased individuals. Survival analyses further underscored malignancy as a major determinant of poor outcomes in patients with IIMs.
1. Duremala F, Tiniakou E, Andrews J. Epidemiology of myositis. Curr Opin Rheumatol. 2025(1);37(2):121-127. doi: 10.1097/BOR.0000000000001076.
2. Schmidt J, Müller-Felber W. Myositis: von der Diagnose zur Therapie [Myositis: from diagnosis to treatment]. Nervenarzt. 2023;94(6):510-518. doi: 10.1007/s00115-023-01490-8. [Article in German]
3. Marie I. Morbidity and mortality in adult polymyositis and dermatomyositis. Curr Rheumatol Rep. 2012;14(3):275-85. doi: 10.1007/s11926-012-0249-3.
4. Wang H, Lv J, He J, et al. The prevalence and effects of treatments of rapidly progressive interstitial lung disease of dermatomyositis/polymyositis adults: A systematic review and meta-analysis. Autoimmun Rev. 2023;22(8):103335. doi: 10.1016/j.autrev.2023.103335.
5. Cheng L, Li Y, Wu Y, et al. Risk of Early Infection in Idiopathic Inflammatory Myopathies: Cluster Analysis Based on Clinical Features and Biomarkers. Inflammation. 2023;46(3):1036-1046. doi: 10.1007/s10753-023-01790-w.
6. Che WI, Kuja-Halkola R, Hellgren K, et al. Impact of cancer on the mortality of patients with idiopathic inflammatory myopathies by flexible parametric multistate modelling. J Intern Med. 2024;296(4):336-349. doi: 10.1111/joim.20003.
7. Sugiyama Y, Yoshimi R, Tamura M, et al. The predictive prognostic factors for polymyositis/dermatomyositis-associated interstitial lung disease. Arthritis Res Ther. 2018(11);20(1):7. doi: 10.1186/s13075-017-1506-7.
8. Liu S, Zhang Z, Yan S, et al. Risk, risk factors, and screening of malignancies in dermatomyositis: current status and future perspectives. Front Oncol. 2025(4);15:1503140. doi: 10.3389/fonc.2025.1503140.
9. Kardes S, Gupta L, Aggarwal R. Cancer and myositis: Who, when, and how to screen. Best Pract Res Clin Rheumatol. 2022;36(2):101771. doi: 10.1016/j.berh.2022.101771.
10. Selva-O'Callaghan A, Martinez-Gómez X, Trallero-Araguás E, Pinal-Fernández I. The diagnostic work-up of cancer-associated myositis. Curr Opin Rheumatol. 2018;30(6):630-636. doi:10.1097/BOR.0000000000000535.
11. Oldroyd AGS, Allard AB, Callen JP, et al. A systematic review and meta-analysis to inform cancer screening guidelines in idiopathic inflammatory myopathies. Rheumatology (Oxford). 2021(18);60(6):2615-2628. doi: 10.1093/rheumatology/keab166.
12. Wu H, Li X, Xu H, et al. Malignancy in Idiopathic Inflammatory Myopathies: Recent Insights. Clin Rev Allergy Immunol. 2025(18);68(1):83. doi: 10.1007/s12016-025-09080-z.
13. Balci MA, Donmez S, Saritas F, Bas V, Pamuk ON. The epidemiology of dermatomyositis in northwestern Thrace region in Turkey: epidemiology of dermatomyositis in Turkey. Rheumatol Int. 2017;37(9):1519-1525. doi: 10.1007/s00296-017-3710-9.
14. Lundberg IE, Tjärnlund A, Bottai M, et al; 2017 European League Against Rheumatism/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups. Ann Rheum Dis. 2017;76(12):1955-1964. doi: 10.1136/annrheumdis-2017-211468.
15. Ogawa-Momohara M, Muro Y. Myositis-specific and myositis-associated autoantibodies: their clinical characteristics and potential pathogenic roles. Immunol Med. 2025;48(2):104-116. doi: 10.1080/25785826.2024.2413604.
16. Nuño-Nuño L, Joven BE, Carreira PE, et al. Mortality and prognostic factors in idiopathic inflammatory myositis: a retrospective analysis of a large multicenter cohort of Spain. Rheumatol Int. 2017;37(11):1853-1861. doi: 10.1007/s00296-017-3799-x.
17. Limaye V, Luke C, Tucker G, et al. The incidence and associations of malignancy in a large cohort of patients with biopsy-determined idiopathic inflammatory myositis. Rheumatol Int. 2013;33(4):965-971. doi: 10.1007/s00296-012-2489-y.
18. Bolaños JD, Rivera-Londoño R, Hurtado-Bermúdez LJ, et al. Exploring the link between inflammatory myopathies and cancer: A comprehensive retrospective analysis in a Colombian cohort. Reumatol Clin (Engl Ed). 2024;20(7):353-359. doi: 10.1016/j.reumae.2024.07.004.
19. Kannan MA, Sundaram C, Uppin M, Mridula R, Jabeen SA, Borgohain R. Incidence of malignancies in biopsy-proven inflammatory myopathy. Neurol India. 2013;61(2):152-155. doi: 10.4103/0028-3886.111121.
20. Jakubaszek M, Kwiatkowska B, Maślińska M. Polymyositis and dermatomyositis as a risk of developing cancer. Reumatologia. 2015;53(2):101-5. doi: 10.5114/reum.2015.51510.
21. Dani L, Ian Che W, Lundberg IE, Hellgren K, Holmqvist M. Overall and site-specific cancer before and after diagnosis of idiopathic inflammatory myopathies: A nationwide study 2002-2016. Semin Arthritis Rheum. 2021;51(1):331-337. doi: 10.1016/j.semarthrit.2020.12.009.
22. El Hasbani G, Madi M, Zoghbi MASE, Srour L, Uthman I, Jawad AS. The Impact of Tobacco Smoking on Systemic Sclerosis, Idiopathic Inflammatory Myositis, and Systemic Lupus Erythematosus. Clin Med Insights Arthritis Musculoskelet Disord. 2024(15);17:11795441241290522. doi: 10.1177/11795441241290522.
23. Zhou B, Li S, Xie X, Xu S, Li F, Long L. Clinical features and risk factors of lung cancer in elderly patients with dermatomyositis. Thorac Cancer. 2023;14(13):1171-1178. doi: 10.1111/1759-7714.14849.
24. Gudipati A, Rifat S, Uppin M, et al. Comparison of Muscle Biopsy Features with Myositis Autoantibodies in Inflammatory Myopathies: A Pilot Experience. Ann Indian Acad Neurol. 2023;26(4):408-418. doi: 10.4103/aian.
25. Deakin CT, Yasin SA, Simou S, et al; UK Juvenile Dermatomyositis Research Group. Muscle Biopsy Findings in Combination With Myositis-Specific Autoantibodies Aid Prediction of Outcomes in Juvenile Dermatomyositis. Arthritis Rheumatol. 2016;68(11):2806-2816. doi: 10.1002/art.39753.
26. Uchino M, Yamashita S, Uchino K, et al. Muscle biopsy findings predictive of malignancy in rare infiltrative dermatomyositis. Clin Neurol Neurosurg. 2013;115(5):603-606. doi: 10.1016/j.clineuro.2012.07.019.
Copyright (c) 2026 The European Research Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Downloads
Article Information
- Article Type Research Article
- Submitted February 21, 2026
- Published March 14, 2026
- Issue 2026: Online First
- Section Research Article
