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Obstetric APS and cancer
blinded to the group to which the patient was assigned. However, symptomatic cancer diagnosis leaves little room for individual interpretation. Third, incident can- cers remained rare during the follow-up, occurring in only 3.3% of the women, thus limiting the potential for a more precise description of their full association with bio- logical parameters which are not independent of each other. The very low number of symptomatic cancers that were diagnosed in our patients is a strong limitation of the study. A multicenter evaluation including a huge number of cases is necessary. Fourth, aPL antibodies may be a non-causal artifact rather than a direct risk factor.
Our study also has several strengths. It received sub- stantial support from the NOHA administrative region- hospital medical network through which we were able to recruit a substantial number of patients. Only a very small
number of patients were lost to follow-up. The primary outcome was not ambiguous and only objectively-proven clinical events and parameters were analyzed.
In summary, we found an increased incidence of can- cers during the follow-up of women with pure obstetric APS, with a significant association with LA. A very large prospective, multicenter replication study is now needed. If such a study confirms our data, it would legitimate more fundamental studies to elucidate the underlying pathophysiology..
Funding
Financial support was provided by Nîmes University Hospital via an internal funding scheme. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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