History of hypertension, heart disease, and diabetes and ovarian cancer patient survival: evidence from the ovarian cancer association consortium
Autor: | Jo L. Freudenheim, Jennifer A. Doherty, Kunle Odunsi, Brenda Diergaarde, Andrew Berchuck, Barbara Schmalfeldt, Lisa E. Paddock, Joellen M. Schildkraut, Kathryn L. Terry, Allan Jensen, Albina N. Minlikeeva, Rüdiger Klapdor, Helen Steed, Jenny Chang-Claude, Mary Anne Rossing, Anna de Fazio, Martin Kӧbel, Kevin H. Eng, J. Brian Szender, Francesmary Modugno, Beth Y. Karlan, Robert Edwards, Marc T. Goodman, Jolanta Kupryjanczyk, Keitaro Matsuo, Daniel W. Cramer, Michael J. LaMonte, Lambertus A. Kiemeney, Susan J. Jordan, Rikki Cannioto, Penelope M. Webb, Thilo Dӧrk, Leon F.A.G. Massuger, Grace Friel, Estrid Høgdall, Susanne K. Kjaer, Emese Zsiros, Christina M. Nagle, Kirsten B. Moysich, Mika Mizuno, P.C. Mayor, Linda E. Kelemen, Elisa V. Bandera, Peter Hillemanns, Roberta B. Ness, Brahm H. Segal, Harvey A. Risch |
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Rok vydání: | 2016 |
Předmět: |
0301 basic medicine
Oncology Adult Risk Cancer Research medicine.medical_specialty Disease free survival Heart Diseases Adrenergic beta-Antagonists Disease-Free Survival Article 03 medical and health sciences 0302 clinical medicine Internal medicine Diabetes mellitus Epidemiology Diabetes Mellitus Medicine Humans Hypoglycemic Agents Insulin Survival rate Aged Gynecology Ovarian Neoplasms Hematology Women's cancers Radboud Institute for Molecular Life Sciences [Radboudumc 17] business.industry Hypertension heart disease Patient survival Middle Aged medicine.disease 3. Good health Survival Rate 030104 developmental biology 030220 oncology & carcinogenesis Urological cancers Radboud Institute for Health Sciences [Radboudumc 15] Hypertension Female business Ovarian cancer |
Zdroj: | Cancer Causes & Control, 28, 5, pp. 469-486 Cancer Causes & Control, 28, 469-486 |
ISSN: | 1573-7225 0957-5243 |
Popis: | Contains fulltext : 174140.pdf (Publisher’s version ) (Closed access) 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. |
Databáze: | OpenAIRE |
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