Amyotrophic lateral sclerosis with coexisting cancer: a single-center study

Area of Science:

• Neurology
• Oncology

Background:

• Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease.
• The potential association between ALS and malignancy, particularly as a paraneoplastic syndrome, requires investigation.

Purpose of the Study:

• To investigate the occurrence of malignancy in a cohort of patients diagnosed with amyotrophic lateral sclerosis (ALS).
• To identify clinical, electrophysiologic, and outcome features that might differentiate cancer-associated ALS from classical ALS.

Main Methods:

• A cohort of 43 consecutive ALS patients admitted between 2015 and 2019 was enrolled.
• Clinical, electrophysiologic, and outcome data were collected and analyzed.
• Patients were monitored for the presence of concurrent or subsequent cancer diagnoses.

Main Results:

• Malignancy was identified in 5 (11.6%) of the 43 ALS patients.
• The cancers diagnosed included non-small cell lung, endometrium, prostate, and laryngeal carcinoma.
• No significant differences in age of onset, sex, disease duration, clinical or electrophysiological features, or outcomes were observed between ALS patients with and without malignancy.
• Survival beyond two years post-ALS onset was rare in cancer-associated ALS patients, with one exception presenting with flail-leg syndrome.

Conclusions:

• While the association between ALS and cancer in this cohort appeared coincidental and not indicative of a classical paraneoplastic syndrome, the findings underscore the importance of vigilant cancer screening in ALS patients.
• No specific features were identified to distinguish cancer-associated ALS from the classical form of the disease in this study group.