Risk of cancer in patients with Guillain-Barré syndrome (GBS): A population-based study

Maria Claudia Vigliani, Michela Magistrello, Patrizia Polo, Roberto Mutani, Adriano Chiò, A. Calvo, N. Di Vito, M. Vercellino, A. Bertolotto, E. Bottacchi, D. Cocito, M. T. Giordana, M. Leone, L. Mazzini, G. Mora, A. A. Terreni, D. Schiffer, B. Bergamasco, I. Rainero, A. TriboloR. Sciolla, F. Mondino, P. Gaviani, F. Monaco, M. De Mattei, E. Morgando, L. Sosso, M. Gionco, U. Morino, M. Nobili, L. Appendino, D. Piazza, E. Oddenino, W. Liboni, G. Vaula, G. Ferrari, M. Favero, C. Doriguzzi Bozzo, P. Santamaria, U. Massazza, E. Bollani, A. Villani, R. Conti, C. Balzarini, M. Palermo, F. Vergnano, S. Cordera, C. Buffa, M. T. Penza, F. Fassio, P. Meineri, A. Cognazzo, C. Mocellini, A. Dutto, A. Cucatto, C. Cavestro, W. Troni, G. Corso, E. Bottacchi

Research output: Contribution to journalArticle

Abstract

The possible relationship between Guillain-Barré syndrome (GBS) and cancer is still controversial and the existence of a paraneoplastic GBS remains unconfirmed. To better define whether there is a relationship between GBS and malignancy, we compared the observed and the expected number of patients with tumours in a population-based cohort of subjects with GBS. Clinical differences between GBS patients with or without malignancies were analysed. Data were obtained from the Piemonte and Valle d'Aosta Register for GBS (PARGBS) (years 1990-1998). GBS was diagnosed according to NINCDS criteria. The number of expected cases of malignancy in the PARGBS population was calculated using the incidence rate of all types of cancer (ICD codes 140-208) in Piemonte [1985-1987], and in the most important town of this region, that is Turin (years 1993-1997). In the nine-year period, 435 incident patients with GBS were found. Nine of them developed cancer in the six months preceding or following GBS; in seven of them, the diagnosis of cancer and GBS was concomitant. The expected number of malignant tumours was 3.7 (using the incidence in Piemonte) and 3.8 (using the incidence in Turin); therefore, the odds ratios were 2.43 (95% CI, 1.11-4.62) and 2.37 (95% CI, 1.09-4.50), respectively (p <0.01). Although the cases with malignancies were clinically similar to the other cases of GBS observed through the Register, the mortality in GBS patients with cancer was higher and was the final cause of death in two patients affected by severe cancer. These results suggest a possible correlation between some cases of GBS and cancer. However, GBS in cancer patients does not meet all the criteria for paraneoplastic diseases.

Original languageEnglish
Pages (from-to)321-326
Number of pages6
JournalJournal of Neurology
Volume251
Issue number3
DOIs
Publication statusPublished - Mar 2004

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Population
Neoplasms
Incidence
International Classification of Diseases
Registries
Cause of Death
Odds Ratio
Mortality

Keywords

  • Cancer
  • Guillain-Barré syndrome
  • Paraneoplastic
  • Polyneuropathy

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Vigliani, M. C., Magistrello, M., Polo, P., Mutani, R., Chiò, A., Calvo, A., ... Bottacchi, E. (2004). Risk of cancer in patients with Guillain-Barré syndrome (GBS): A population-based study. Journal of Neurology, 251(3), 321-326. https://doi.org/10.1007/s00415-004-0317-3

Risk of cancer in patients with Guillain-Barré syndrome (GBS) : A population-based study. / Vigliani, Maria Claudia; Magistrello, Michela; Polo, Patrizia; Mutani, Roberto; Chiò, Adriano; Calvo, A.; Di Vito, N.; Vercellino, M.; Bertolotto, A.; Bottacchi, E.; Cocito, D.; Giordana, M. T.; Leone, M.; Mazzini, L.; Mora, G.; Terreni, A. A.; Schiffer, D.; Bergamasco, B.; Rainero, I.; Tribolo, A.; Sciolla, R.; Mondino, F.; Gaviani, P.; Monaco, F.; De Mattei, M.; Morgando, E.; Sosso, L.; Gionco, M.; Morino, U.; Nobili, M.; Appendino, L.; Piazza, D.; Oddenino, E.; Liboni, W.; Vaula, G.; Ferrari, G.; Favero, M.; Doriguzzi Bozzo, C.; Santamaria, P.; Massazza, U.; Bollani, E.; Villani, A.; Conti, R.; Balzarini, C.; Palermo, M.; Vergnano, F.; Cordera, S.; Buffa, C.; Penza, M. T.; Fassio, F.; Meineri, P.; Cognazzo, A.; Mocellini, C.; Dutto, A.; Cucatto, A.; Cavestro, C.; Troni, W.; Corso, G.; Bottacchi, E.

In: Journal of Neurology, Vol. 251, No. 3, 03.2004, p. 321-326.

Research output: Contribution to journalArticle

Vigliani, MC, Magistrello, M, Polo, P, Mutani, R, Chiò, A, Calvo, A, Di Vito, N, Vercellino, M, Bertolotto, A, Bottacchi, E, Cocito, D, Giordana, MT, Leone, M, Mazzini, L, Mora, G, Terreni, AA, Schiffer, D, Bergamasco, B, Rainero, I, Tribolo, A, Sciolla, R, Mondino, F, Gaviani, P, Monaco, F, De Mattei, M, Morgando, E, Sosso, L, Gionco, M, Morino, U, Nobili, M, Appendino, L, Piazza, D, Oddenino, E, Liboni, W, Vaula, G, Ferrari, G, Favero, M, Doriguzzi Bozzo, C, Santamaria, P, Massazza, U, Bollani, E, Villani, A, Conti, R, Balzarini, C, Palermo, M, Vergnano, F, Cordera, S, Buffa, C, Penza, MT, Fassio, F, Meineri, P, Cognazzo, A, Mocellini, C, Dutto, A, Cucatto, A, Cavestro, C, Troni, W, Corso, G & Bottacchi, E 2004, 'Risk of cancer in patients with Guillain-Barré syndrome (GBS): A population-based study', Journal of Neurology, vol. 251, no. 3, pp. 321-326. https://doi.org/10.1007/s00415-004-0317-3
Vigliani, Maria Claudia ; Magistrello, Michela ; Polo, Patrizia ; Mutani, Roberto ; Chiò, Adriano ; Calvo, A. ; Di Vito, N. ; Vercellino, M. ; Bertolotto, A. ; Bottacchi, E. ; Cocito, D. ; Giordana, M. T. ; Leone, M. ; Mazzini, L. ; Mora, G. ; Terreni, A. A. ; Schiffer, D. ; Bergamasco, B. ; Rainero, I. ; Tribolo, A. ; Sciolla, R. ; Mondino, F. ; Gaviani, P. ; Monaco, F. ; De Mattei, M. ; Morgando, E. ; Sosso, L. ; Gionco, M. ; Morino, U. ; Nobili, M. ; Appendino, L. ; Piazza, D. ; Oddenino, E. ; Liboni, W. ; Vaula, G. ; Ferrari, G. ; Favero, M. ; Doriguzzi Bozzo, C. ; Santamaria, P. ; Massazza, U. ; Bollani, E. ; Villani, A. ; Conti, R. ; Balzarini, C. ; Palermo, M. ; Vergnano, F. ; Cordera, S. ; Buffa, C. ; Penza, M. T. ; Fassio, F. ; Meineri, P. ; Cognazzo, A. ; Mocellini, C. ; Dutto, A. ; Cucatto, A. ; Cavestro, C. ; Troni, W. ; Corso, G. ; Bottacchi, E. / Risk of cancer in patients with Guillain-Barré syndrome (GBS) : A population-based study. In: Journal of Neurology. 2004 ; Vol. 251, No. 3. pp. 321-326.
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abstract = "The possible relationship between Guillain-Barr{\'e} syndrome (GBS) and cancer is still controversial and the existence of a paraneoplastic GBS remains unconfirmed. To better define whether there is a relationship between GBS and malignancy, we compared the observed and the expected number of patients with tumours in a population-based cohort of subjects with GBS. Clinical differences between GBS patients with or without malignancies were analysed. Data were obtained from the Piemonte and Valle d'Aosta Register for GBS (PARGBS) (years 1990-1998). GBS was diagnosed according to NINCDS criteria. The number of expected cases of malignancy in the PARGBS population was calculated using the incidence rate of all types of cancer (ICD codes 140-208) in Piemonte [1985-1987], and in the most important town of this region, that is Turin (years 1993-1997). In the nine-year period, 435 incident patients with GBS were found. Nine of them developed cancer in the six months preceding or following GBS; in seven of them, the diagnosis of cancer and GBS was concomitant. The expected number of malignant tumours was 3.7 (using the incidence in Piemonte) and 3.8 (using the incidence in Turin); therefore, the odds ratios were 2.43 (95{\%} CI, 1.11-4.62) and 2.37 (95{\%} CI, 1.09-4.50), respectively (p <0.01). Although the cases with malignancies were clinically similar to the other cases of GBS observed through the Register, the mortality in GBS patients with cancer was higher and was the final cause of death in two patients affected by severe cancer. These results suggest a possible correlation between some cases of GBS and cancer. However, GBS in cancer patients does not meet all the criteria for paraneoplastic diseases.",
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AU - Vigliani, Maria Claudia

AU - Magistrello, Michela

AU - Polo, Patrizia

AU - Mutani, Roberto

AU - Chiò, Adriano

AU - Calvo, A.

AU - Di Vito, N.

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AU - Bertolotto, A.

AU - Bottacchi, E.

AU - Cocito, D.

AU - Giordana, M. T.

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AU - Mora, G.

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AU - Monaco, F.

AU - De Mattei, M.

AU - Morgando, E.

AU - Sosso, L.

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AU - Nobili, M.

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AU - Conti, R.

AU - Balzarini, C.

AU - Palermo, M.

AU - Vergnano, F.

AU - Cordera, S.

AU - Buffa, C.

AU - Penza, M. T.

AU - Fassio, F.

AU - Meineri, P.

AU - Cognazzo, A.

AU - Mocellini, C.

AU - Dutto, A.

AU - Cucatto, A.

AU - Cavestro, C.

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AU - Corso, G.

AU - Bottacchi, E.

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N2 - The possible relationship between Guillain-Barré syndrome (GBS) and cancer is still controversial and the existence of a paraneoplastic GBS remains unconfirmed. To better define whether there is a relationship between GBS and malignancy, we compared the observed and the expected number of patients with tumours in a population-based cohort of subjects with GBS. Clinical differences between GBS patients with or without malignancies were analysed. Data were obtained from the Piemonte and Valle d'Aosta Register for GBS (PARGBS) (years 1990-1998). GBS was diagnosed according to NINCDS criteria. The number of expected cases of malignancy in the PARGBS population was calculated using the incidence rate of all types of cancer (ICD codes 140-208) in Piemonte [1985-1987], and in the most important town of this region, that is Turin (years 1993-1997). In the nine-year period, 435 incident patients with GBS were found. Nine of them developed cancer in the six months preceding or following GBS; in seven of them, the diagnosis of cancer and GBS was concomitant. The expected number of malignant tumours was 3.7 (using the incidence in Piemonte) and 3.8 (using the incidence in Turin); therefore, the odds ratios were 2.43 (95% CI, 1.11-4.62) and 2.37 (95% CI, 1.09-4.50), respectively (p <0.01). Although the cases with malignancies were clinically similar to the other cases of GBS observed through the Register, the mortality in GBS patients with cancer was higher and was the final cause of death in two patients affected by severe cancer. These results suggest a possible correlation between some cases of GBS and cancer. However, GBS in cancer patients does not meet all the criteria for paraneoplastic diseases.

AB - The possible relationship between Guillain-Barré syndrome (GBS) and cancer is still controversial and the existence of a paraneoplastic GBS remains unconfirmed. To better define whether there is a relationship between GBS and malignancy, we compared the observed and the expected number of patients with tumours in a population-based cohort of subjects with GBS. Clinical differences between GBS patients with or without malignancies were analysed. Data were obtained from the Piemonte and Valle d'Aosta Register for GBS (PARGBS) (years 1990-1998). GBS was diagnosed according to NINCDS criteria. The number of expected cases of malignancy in the PARGBS population was calculated using the incidence rate of all types of cancer (ICD codes 140-208) in Piemonte [1985-1987], and in the most important town of this region, that is Turin (years 1993-1997). In the nine-year period, 435 incident patients with GBS were found. Nine of them developed cancer in the six months preceding or following GBS; in seven of them, the diagnosis of cancer and GBS was concomitant. The expected number of malignant tumours was 3.7 (using the incidence in Piemonte) and 3.8 (using the incidence in Turin); therefore, the odds ratios were 2.43 (95% CI, 1.11-4.62) and 2.37 (95% CI, 1.09-4.50), respectively (p <0.01). Although the cases with malignancies were clinically similar to the other cases of GBS observed through the Register, the mortality in GBS patients with cancer was higher and was the final cause of death in two patients affected by severe cancer. These results suggest a possible correlation between some cases of GBS and cancer. However, GBS in cancer patients does not meet all the criteria for paraneoplastic diseases.

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