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, 28 5: 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
0957-5243
Publication date 2017-03-14
Sub-type Article (original research)
DOI 10.1007/s10552-017-0867-1
Open Access Status Not yet assessed
Volume 28
Issue 5
Start page 1
End page 18
Total pages 18
Place of publication Dordrecht, Netherlands
Publisher Springer Netherlands
Language eng
Subject 2730 Oncology
1306 Cancer Research
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.
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
Diabetes
Hypertension
Medications
Mortality
Ovarian cancer prognosis
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID DAMD170210666
DAMD170210669
K07 CA095666
K07CA080668
K22CA138563
P30CA072720
P50CA105009
P50CA159981
R0195023
R01CA126841
R01CA54419
R01CA61107
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R25CA113951
SIOP0625801 COUN
UL1TR000124
W81XWH10102802
199600
2R25CA113951
400281
5T32CA108456
K01LM012100
MOP-86727
N01CN55424
N01PC67001
P50CA159981
R01CA074850
R01CA080742
R01CA095023
R01CA112523
R01CA126841
R01CA188900
R01CA58598
R01CA87538
Institutional Status UQ

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Sub-type: Article (original research)
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