History of hypertension, heart disease, and diabetes and ovarian cancer patient survival: evidence from the ovarian cancer association consortium

Minlikeeva, Albina N. , Freudenheim, Jo L., Cannioto, Rikki A., Szender, J. Brian, Eng, Kevin H., Modugno, Francesmary, Ness, Roberta B., LaMonte, Michael J., Friel, Grace, Segal, Brahm H., Odunsi, Kunle, Mayor, Paul , Zsiros, Emese, Schmalfeldt, Barbara, Klapdor, Rüdiger, Dӧrk, Thilo, Hillemanns, Peter, Kelemen, Linda E., Kӧbel, Martin, Steed, Helen, de Fazio, Anna, Jordan, Susan J. , Nagle, Christina M., Risch, Harvey A., Rossing, Mary Anne, Doherty, Jennifer A., Goodman, Marc T. , Edwards, Robert, Matsuo, Keitaro, Mizuno, Mika, Karlan, Beth Y., Kjaer, Susanne K., Hogdall, Estrid, Jensen, Allan , Schildkraut, Joellen M. , Terry, Kathryn L., Cramer, Daniel W., Bandera, Elisa V. , Paddock, Lisa E. , Kiemeney, Lambertus A., Massuger, Leon F., Kupryjanczyk, Jolanta, Berchuck, Andrew, Chang-Claude, Jenny, Diergaarde, Brenda, Webb, Penelope M. and Moysich, Kirsten B. (2017) History of hypertension, heart disease, and diabetes and ovarian cancer patient survival: evidence from the ovarian cancer association consortium. Cancer Causes and Control, 1-18. doi:10.1007/s10552-017-0867-1

Author Minlikeeva, Albina N. 
Freudenheim, Jo L.
Cannioto, Rikki A.
Szender, J. Brian
Eng, Kevin H.
Modugno, Francesmary
Ness, Roberta B.
LaMonte, Michael J.
Friel, Grace
Segal, Brahm H.
Odunsi, Kunle
Mayor, Paul 
Zsiros, Emese
Schmalfeldt, Barbara
Klapdor, Rüdiger
Dӧrk, Thilo
Hillemanns, Peter
Kelemen, Linda E.
Kӧbel, Martin
Steed, Helen
de Fazio, Anna
Jordan, Susan J. 
Nagle, Christina M.
Risch, Harvey A.
Rossing, Mary Anne
Doherty, Jennifer A.
Goodman, Marc T. 
Edwards, Robert
Matsuo, Keitaro
Mizuno, Mika
Karlan, Beth Y.
Kjaer, Susanne K.
Hogdall, Estrid
Jensen, Allan 
Schildkraut, Joellen M. 
Terry, Kathryn L.
Cramer, Daniel W.
Bandera, Elisa V. 
Paddock, Lisa E. 
Kiemeney, Lambertus A.
Massuger, Leon F.
Kupryjanczyk, Jolanta
Berchuck, Andrew
Chang-Claude, Jenny
Diergaarde, Brenda
Webb, Penelope M.
Moysich, Kirsten B.
Title History of hypertension, heart disease, and diabetes and ovarian cancer patient survival: evidence from the ovarian cancer association consortium
Journal name Cancer Causes and Control   Check publisher's open access policy
ISSN 1573-7225
Publication date 2017-03-14
Sub-type Article (original research)
DOI 10.1007/s10552-017-0867-1
Open Access Status Not yet assessed
Start page 1
End page 18
Total pages 18
Place of publication Dordrecht, Netherlands
Publisher Springer Netherlands
Collection year 2018
Language eng
Formatted abstract
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.
Keyword Beta blockers
Ovarian cancer prognosis
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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