TY - JOUR
T1 - History of hypertension, heart disease, and diabetes and ovarian cancer patient survival
T2 - evidence from the ovarian cancer association consortium
AU - Minlikeeva, Albina N
AU - Freudenheim, Jo L
AU - Cannioto, Rikki A
AU - Szender, J Brian
AU - Eng, Kevin H
AU - Modugno, Francesmary
AU - Ness, Roberta B
AU - LaMonte, Michael J
AU - Friel, Grace
AU - Segal, Brahm H
AU - Odunsi, Kunle
AU - Mayor, Paul
AU - Zsiros, Emese
AU - Schmalfeldt, Barbara
AU - Klapdor, Rüdiger
AU - Dӧrk, Thilo
AU - Hillemanns, Peter
AU - Kelemen, Linda E
AU - Kӧbel, Martin
AU - Steed, Helen
AU - de Fazio, Anna
AU - Jordan, Susan J
AU - Nagle, Christina M
AU - Risch, Harvey A
AU - Rossing, Mary Anne
AU - Doherty, Jennifer A
AU - Goodman, Marc T
AU - Edwards, Robert
AU - Matsuo, Keitaro
AU - Mizuno, Mika
AU - Karlan, Beth Y
AU - Kjær, Susanne K
AU - Høgdall, Estrid
AU - Jensen, Allan
AU - Schildkraut, Joellen M
AU - Terry, Kathryn L
AU - Cramer, Daniel W
AU - Bandera, Elisa V
AU - Paddock, Lisa E
AU - Kiemeney, Lambertus A
AU - Massuger, Leon F
AU - Kupryjanczyk, Jolanta
AU - Berchuck, Andrew
AU - Chang-Claude, Jenny
AU - Diergaarde, Brenda
AU - Webb, Penelope M
AU - Moysich, Kirsten B
AU - Australian Ovarian Cancer Study Group
PY - 2017/5/1
Y1 - 2017/5/1
N2 - PURPOSE: Survival following ovarian cancer diagnosis is generally low; understanding factors related to prognosis could be important to optimize treatment. The role of previously diagnosed comorbidities and use of medications for those conditions in relation to prognosis for ovarian cancer patients has not been studied extensively, particularly according to histological subtype.METHODS: Using pooled data from fifteen studies participating in the Ovarian Cancer Association Consortium, we examined the associations between history of hypertension, heart disease, diabetes, and medications taken for these conditions and overall survival (OS) and progression-free survival (PFS) among patients diagnosed with invasive epithelial ovarian carcinoma. We used Cox proportional hazards regression models adjusted for age and stage to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) overall and within strata of histological subtypes.RESULTS: History of diabetes was associated with increased risk of mortality (n = 7,674; HR = 1.12; 95% CI = 1.01-1.25). No significant mortality associations were observed for hypertension (n = 6,482; HR = 0.95; 95% CI = 0.88-1.02) or heart disease (n = 4,252; HR = 1.05; 95% CI = 0.87-1.27). No association of these comorbidities was found with PFS in the overall study population. However, among patients with endometrioid tumors, hypertension was associated with lower risk of progression (n = 339, HR = 0.54; 95% CI = 0.35-0.84). Comorbidity was not associated with OS or PFS for any of the other histological subtypes. Ever use of beta blockers, oral antidiabetic medications, and insulin was associated with increased mortality, HR = 1.20; 95% CI = 1.03-1.40, HR = 1.28; 95% CI = 1.05-1.55, and HR = 1.63; 95% CI = 1.20-2.20, respectively. Ever use of diuretics was inversely associated with mortality, HR = 0.71; 95% CI = 0.53-0.94.CONCLUSIONS: Histories of hypertension, diabetes, and use of diuretics, beta blockers, insulin, and oral antidiabetic medications may influence the survival of ovarian cancer patients. Understanding mechanisms for these observations could provide insight regarding treatment.
AB - PURPOSE: Survival following ovarian cancer diagnosis is generally low; understanding factors related to prognosis could be important to optimize treatment. The role of previously diagnosed comorbidities and use of medications for those conditions in relation to prognosis for ovarian cancer patients has not been studied extensively, particularly according to histological subtype.METHODS: Using pooled data from fifteen studies participating in the Ovarian Cancer Association Consortium, we examined the associations between history of hypertension, heart disease, diabetes, and medications taken for these conditions and overall survival (OS) and progression-free survival (PFS) among patients diagnosed with invasive epithelial ovarian carcinoma. We used Cox proportional hazards regression models adjusted for age and stage to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) overall and within strata of histological subtypes.RESULTS: History of diabetes was associated with increased risk of mortality (n = 7,674; HR = 1.12; 95% CI = 1.01-1.25). No significant mortality associations were observed for hypertension (n = 6,482; HR = 0.95; 95% CI = 0.88-1.02) or heart disease (n = 4,252; HR = 1.05; 95% CI = 0.87-1.27). No association of these comorbidities was found with PFS in the overall study population. However, among patients with endometrioid tumors, hypertension was associated with lower risk of progression (n = 339, HR = 0.54; 95% CI = 0.35-0.84). Comorbidity was not associated with OS or PFS for any of the other histological subtypes. Ever use of beta blockers, oral antidiabetic medications, and insulin was associated with increased mortality, HR = 1.20; 95% CI = 1.03-1.40, HR = 1.28; 95% CI = 1.05-1.55, and HR = 1.63; 95% CI = 1.20-2.20, respectively. Ever use of diuretics was inversely associated with mortality, HR = 0.71; 95% CI = 0.53-0.94.CONCLUSIONS: Histories of hypertension, diabetes, and use of diuretics, beta blockers, insulin, and oral antidiabetic medications may influence the survival of ovarian cancer patients. Understanding mechanisms for these observations could provide insight regarding treatment.
KW - Adrenergic beta-Antagonists/therapeutic use
KW - Adult
KW - Aged
KW - Diabetes Mellitus/drug therapy
KW - Disease-Free Survival
KW - Female
KW - Heart Diseases/complications
KW - Humans
KW - Hypertension/complications
KW - Hypoglycemic Agents/therapeutic use
KW - Insulin/therapeutic use
KW - Middle Aged
KW - Ovarian Neoplasms/complications
KW - Risk
KW - Survival Rate
U2 - 10.1007/s10552-017-0867-1
DO - 10.1007/s10552-017-0867-1
M3 - Journal article
C2 - 28293802
SN - 0957-5243
VL - 28
SP - 469
EP - 486
JO - Cancer Causes & Control
JF - Cancer Causes & Control
IS - 5
ER -