Figures
- FIGURE 1
Flowchart showing the selection of cases of cancer with sarcoid-like granuloma. UM: University of Miami; EBUS-TBNA: endobronchial ultrasound transbronchial needle aspiration.
- FIGURE 2
Logistic regression with stepwise elimination for factors affecting stage 4 metastasis; p-value from Hosmer and Lemeshow goodness-of-fit test=0.107. The rhombus shape indicates the odds ratio (OR), and the horizontal line indicates the confidence interval (CI). The arrow indicates that the 95% CI is outside the range shown. MAB: monoclonal antibody therapy
- FIGURE 3
Multivariate Cox proportional hazard analysis of survival of cancer patients with and without sarcoid-like granulomas.
- FIGURE 4
Logistic regression with stepwise elimination for factors affecting survival; p-value from Hosmer and Lemeshow goodness-of-fit test=1.000. The rhombus shape indicates the odds ratio (OR), and the horizontal line indicates the confidence interval (CI). The arrow indicates that the 95% CI is outside the range shown. MAB: monoclonal antibody therapy.
- FIGURE 5
Kaplan–Meier survival analysis showing the survival curve for the most common cancers among controls and cases. a) Breast cancer (granuloma=8, no granuloma=37, OR 0.55, 0.24–1.3); b) Melanoma (granuloma=5, no granuloma=18, OR 0.79, 0.27–2.25); c) Lymphoma (granuloma=6, no granuloma=15, OR 1.19, 0.43–3.28); d) Lung cancer (granuloma=6, no granuloma=30, OR 0.52, 0.2–1.34). The curves illustrate the proportion of subjects at each time point who were alive. The p-value was calculated by the log-rank test.
Tables
- TABLE 1
Characteristics of patients with cancer and sarcoidosis
Female n (%) 72 (54.2) Age at time of sarcoid-like granuloma diagnosis years mean/median 64.5/65 Underlying cancer n (%) Skin cancer 30 (22.5) Breast cancer 27 (20.3) Lymph cancer 17 (12.7) Prostate cancer 14 (10.5) Lung cancer 12 (9) Colon cancer 9 (6.7) Urinary bladder cancer 8(6.0) Cervical cancer 7 (5.3) Head and neck cancer 6 (4.5) Sarcoma 5 (3.8) Kidney cancer 5 (3.8) Pancreatic cancer 4 (3.0) Conjunctival cancer 1 (0.7) Cancer treatment before diagnosis of sarcoidosis n (%) Surgery 91 (68.4) Chemotherapy 54 (40.6) Radiation 38 (28.6) Chemotherapy agents before diagnosis of sarcoidosis n (%) Doxorubicin 15 (11.3) Cisplatin 11 (8.2) Cyclophosphamide 11 (8.2) Gemcitabine 9 (6.7) 5-Fluorouracil 9 (6.7) Carboplatin 9 (6.7) Rituximab 9 (6.7) MAB treatment before cancer diagnosis n (%) Anti-CD20 9 (6.7) PD-1 immune checkpoint 4 (3) Anti-Her2neu 2 (1.5) Anti-CTLA4 2 (1.5) Anti-VEGF 1 (0.75) Cancer stage at time of sarcoid-like granuloma diagnosis Stage 1 24 (15.8) Stage 2 17 (12) Stage 3 18 (12.7) Stage 4 12 (7.5) Interval between cancer and sarcoid-like granulomas n(%) <1 year 24 (18.9) 1–5 years 54 (42.5) >5 years 49 (38.5) Most common symptom at time of sarcoidosis diagnosis n (%) Dyspnoea 20 (15) Cough 18 (13.5) Fatigue 16 (12) Smoking n (%) Current 7 (5.2) Past 48 (36.1) Never smoker 76 (57.1) Mean number of years of smoking 28.5 Sarcoidosis stage at the time of diagnosis n (%) Stage 1 51 (38.3) Stage 2 73 (54.9) Stage 3 5 (3.7) Stage 4 2 (1.5) - TABLE 2
Univariate analysis of demographic characteristics and clinical pathological characteristics of cancer subjects with and without sarcoid-like granuloma
Variable Cancer only Cancer and granuloma p-value OR (95 CI) Subjects n 134 46 – – Age at cancer diagnosis 57.9±14.3 58.3±12.96 0.860 – Average years of follow-up 6.0±6.4 5.5±5.1 0.615 Male 53 (39.5) 24 (52.1) 0.137 1.67 (0.85–3.27) European-American 56 (41.8) 16 (34.8) 0.403 0.74 (0.37–1.49) Hispanic 57 (42.5) 12 (26.1) 0.050 0.48 (0.23–1) African American 17 (12.7) 8 (17.4) 0.428 1.45 (0.58–3.62) Asian 2 (1.4) 8 (17.4) 0.001 13.90 (2.83–68.2) Smokers 70 (52.2) 17 (36.9) 0.087 0.55 (0.27–1.09) Average years of smoking 30.92 36.4 0.243 – Alive <2 years 20 (46.5) 12 (80) 0.033 4.6 (1.13–18.65) Alive <4 years 40 (50.6) 20 (80) 0.013 3.9 (1.33–11.42) Alive <6 years 48 (51.1) 30 (85.7) 0.001 5.75 (2.05–16.1) Alive <10 years 57 (51.3) 35 (85.4) <0.0001 5.53 (2.15–14.18) Alive >10 years 16 (69.6) 5 (100) – – Bladder cancer 7 (5.2) 3 (6.5) 0.741 1.27 (0.31–5.11) Breast cancer 37 (27.7) 8 (17.4) 0.171 0.55 (0.24–1.3) Colon cancer 7 (5.2) 5 (10.9) 0.195 2.21 (0.67–7.35) Lung cancer 30 (22.4) 6 (13) 0.177 0.52 (0.2–1.34) Lymphoma 15 (11.2) 6 (13) 0.736 1.19 (0.43–3.28) Melanoma 18 (13.4) 5 (10.9) 0.654 0.79 (0.27–2.25) Pancreatic cancer 4 (3) 3 (6.5) 0.296 2.27 (0.49–10.54) RCC 8 (6) 1 (2.2) 0.329 0.35 (0.04–2.88) Sarcoma 2 (1.5) 3 (6.5) 0.100 4.61 (0.75–28.48) Prostate cancer 6 (4.4) 6 (13) 0.055 3.2 (0.97–10.47) Cancer stage 4 72 (57.6) 6 (13) <0.0001 0.17 (0.07–0.44) Surgery 86 (67.2) 26 (56.5) 0.798 0.91 (0.43–1.92) Radiotherapy 69 (53.9) 13 (28.3) 0.020 0.41 (0.2–0.87) Chemotherapy 90 (70.3) 20 (43.5) 0.020 0.42 (0.20–0.87) mAb therapy 55 (43.0) 8 (17.4) 0.011 0.33 (0.14–0.78) Data are presented as mean±sd or n (%), unless otherwise stated. RCC: renal cell carcinoma; mAb: monoclonal antibody therapy.
