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

TY - JOUR

T1 - History of hypertension, heart disease, and diabetes and ovarian cancer patient survival: 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 Z

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 A G

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

PY - 2017/5

Y1 - 2017/5

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 - Journal Article

U2 - 10.1007/s10552-017-0867-1

DO - 10.1007/s10552-017-0867-1

M3 - SCORING: Journal article

C2 - 28293802

VL - 28

SP - 469

EP - 486

JO - CANCER CAUSE CONTROL

JF - CANCER CAUSE CONTROL

SN - 0957-5243

IS - 5

ER -