Cigarette smoking is associated with adverse survival among women with ovarian cancer

TY - JOUR

T1 - Cigarette smoking is associated with adverse survival among women with ovarian cancer

T2 - Results from a pooled analysis of 19 studies

AU - Praestegaard, Camilla

AU - Jensen, Allan

AU - Jensen, Signe M

AU - Nielsen, Thor S S

AU - Webb, Penelope M

AU - Nagle, Christina M

AU - deFazio, Anna

AU - Høgdall, Estrid

AU - Rossing, Mary Anne

AU - Doherty, Jennifer A

AU - Wicklund, Kristine G

AU - Goodman, Marc T

AU - Modugno, Francesmary

AU - Moysich, Kirsten B

AU - Ness, Roberta B

AU - Edwards, Robert

AU - Matsuo, Keitaro

AU - Hosono, Satoyo

AU - Goode, Ellen L

AU - Winham, Stacey J

AU - Fridley, Brooke L

AU - Cramer, Daniel W

AU - Terry, Kathryn L

AU - Schildkraut, Joellen M

AU - Berchuck, Andrew

AU - Bandera, Elisa V

AU - Paddock, Lisa E

AU - Massuger, Leon F A G

AU - Wentzensen, Nicolas

AU - Pharoah, Paul

AU - Song, Honglin

AU - Whittemore, Alice S

AU - McGuire, Valerie

AU - Sieh, Weiva

AU - Rothstein, Joseph

AU - Anton-Culver, Hoda

AU - Ziogas, Argyrios

AU - Menon, Usha

AU - Gayther, Simon A

AU - Ramus, Susan J

AU - Gentry-Maharaj, Alexandra

AU - Wu, Anna H

AU - Pearce, Celeste L

AU - Pike, Malcolm C

AU - Lee, Alice W

AU - Sutphen, Rebecca

AU - Chang-Claude, Jenny

AU - Risch, Harvey A

AU - Kjaer, Susanne Krüger

AU - Australian Ovarian Cancer Study

N1 - © 2017 UICC.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Cigarette smoking is associated with an increased risk of developing mucinous ovarian tumors but whether it is associated with ovarian cancer survival overall or for the different histotypes is unestablished. Furthermore, it is unknown whether the association between cigarette smoking and survival differs according to strata of ovarian cancer stage at diagnosis. In a large pooled analysis, we evaluated the association between various measures of cigarette smoking and survival among women with epithelial ovarian cancer. We obtained data from 19 case-control studies in the Ovarian Cancer Association Consortium (OCAC), including 9,114 women diagnosed with ovarian cancer. Cox regression models were used to estimate adjusted study-specific hazard ratios (HRs), which were combined into pooled hazard ratios (pHR) with corresponding 95% confidence intervals (CIs) under random effects models. Overall, 5,149 (57%) women died during a median follow-up period of 7.0 years. Among women diagnosed with ovarian cancer, both current (pHR = 1.17, 95% CI: 1.08-1.28) and former smokers (pHR = 1.10, 95% CI: 1.02-1.18) had worse survival compared with never smoking women. In histotype-stratified analyses, associations were observed for mucinous (current smoking: pHR = 1.91, 95% CI: 1.01-3.65) and serous histotypes (current smoking: pHR = 1.11, 95% CI: 1.00-1.23; former smoking: pHR = 1.12, 95% CI: 1.04-1.20). Further, our results suggested that current smoking has a greater impact on survival among women with localized than disseminated disease. The identification of cigarette smoking as a modifiable factor associated with survival has potential clinical importance as a focus area to improve ovarian cancer prognosis.

AB - Cigarette smoking is associated with an increased risk of developing mucinous ovarian tumors but whether it is associated with ovarian cancer survival overall or for the different histotypes is unestablished. Furthermore, it is unknown whether the association between cigarette smoking and survival differs according to strata of ovarian cancer stage at diagnosis. In a large pooled analysis, we evaluated the association between various measures of cigarette smoking and survival among women with epithelial ovarian cancer. We obtained data from 19 case-control studies in the Ovarian Cancer Association Consortium (OCAC), including 9,114 women diagnosed with ovarian cancer. Cox regression models were used to estimate adjusted study-specific hazard ratios (HRs), which were combined into pooled hazard ratios (pHR) with corresponding 95% confidence intervals (CIs) under random effects models. Overall, 5,149 (57%) women died during a median follow-up period of 7.0 years. Among women diagnosed with ovarian cancer, both current (pHR = 1.17, 95% CI: 1.08-1.28) and former smokers (pHR = 1.10, 95% CI: 1.02-1.18) had worse survival compared with never smoking women. In histotype-stratified analyses, associations were observed for mucinous (current smoking: pHR = 1.91, 95% CI: 1.01-3.65) and serous histotypes (current smoking: pHR = 1.11, 95% CI: 1.00-1.23; former smoking: pHR = 1.12, 95% CI: 1.04-1.20). Further, our results suggested that current smoking has a greater impact on survival among women with localized than disseminated disease. The identification of cigarette smoking as a modifiable factor associated with survival has potential clinical importance as a focus area to improve ovarian cancer prognosis.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Case-Control Studies

KW - Female

KW - Humans

KW - Middle Aged

KW - Neoplasms, Glandular and Epithelial

KW - Ovarian Neoplasms

KW - Proportional Hazards Models

KW - Risk Factors

KW - Smoking

KW - Tobacco

KW - Young Adult

KW - Journal Article

U2 - 10.1002/ijc.30600

DO - 10.1002/ijc.30600

M3 - SCORING: Journal article

C2 - 28063166

VL - 140

SP - 2422

EP - 2435

JO - INT J CANCER

JF - INT J CANCER

SN - 0020-7136

IS - 11

ER -