Journal
CANCER CAUSES & CONTROL
Volume 28, Issue 5, Pages 469-486Publisher
SPRINGER
DOI: 10.1007/s10552-017-0867-1
Keywords
Ovarian cancer prognosis; Hypertension; Diabetes; Medications; Mortality; Beta blockers
Funding
- National Cancer Institute (NCI) [R25CA113951]
- National Institute of Health (NIH)/NCI [2R25CA113951]
- NIH/NCI [2R25CA113951, R01CA095023, R01CA126841, P50CA159981, K07-CA080668, R01-CA95023, P50-CA159981, R01-CA126841, K07 CA095666, K22-CA138563, P30-CA072720]
- NIH/NLM [K01LM012100]
- Roswell Park Alliance Foundation
- NIH [R01CA188900, R01-CA074850, R01-CA080742, R01-CA112523, R01-CA87538, R01-CA58598, N01-CN-55424, N01-PC-67001, R01-CA54419, P50-CA105009]
- Canadian Institutes for Health Research [MOP-86727]
- U. S. Army Medical Research and Materiel Command [DAMD17-01-1-0729]
- National Health & Medical Research Council of Australia [199600, 400281]
- Cancer Council of New South Wales
- Cancer Council of Victoria
- Cancer Council of Queensland
- Cancer Council of South Australia
- Cancer Council of Tasmania
- Cancer Foundation of Western Australia
- German Federal Ministry of Education and Research
- Program of Clinical Biomedical Research [01GB9401]
- German Cancer Research Center
- Department of Defense (DOD) [DAMD17-02-1-0669]
- Ministry of Health, Labour and Welfare
- American Cancer Society Early Detection Professorship [SIOP-06-258-01-COUN]
- National Center for Advancing Translational Sciences (NCATS) [UL1TR000124]
- Danish Cancer Society [94 222 52]
- Mermaid I project
- DOD [DAMD17-02-1-0666, W81XWH-10-1-02802]
- Radboud University Medical Centre
- Polish Ministry of Science and Higher Education [4 PO5C 028 14, 2 PO5A 068 27]
- Maria Sklodowska-Curie Memorial Cancer Center
- Institute of Oncology, Warsaw, Poland
- [5T32CA108456]
Ask authors/readers for more resources
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. 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. 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. 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.
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