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

Publication ,  Journal Article
Minlikeeva, AN; Freudenheim, JL; Cannioto, RA; Szender, JB; Eng, KH; Modugno, F; Ness, RB; LaMonte, MJ; Friel, G; Segal, BH; Odunsi, K ...
Published in: Cancer Causes Control
May 2017

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.

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Published In

Cancer Causes Control

DOI

EISSN

1573-7225

Publication Date

May 2017

Volume

28

Issue

5

Start / End Page

469 / 486

Location

Netherlands

Related Subject Headings

  • Survival Rate
  • Risk
  • Ovarian Neoplasms
  • Middle Aged
  • Insulin
  • Hypoglycemic Agents
  • Hypertension
  • Humans
  • Heart Diseases
  • Female
 

Citation

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Minlikeeva, A. N., Freudenheim, J. L., Cannioto, R. A., Szender, J. B., Eng, K. H., Modugno, F., … Ovarian Cancer Association Consortium, . (2017). History of hypertension, heart disease, and diabetes and ovarian cancer patient survival: evidence from the ovarian cancer association consortium. Cancer Causes Control, 28(5), 469–486. https://doi.org/10.1007/s10552-017-0867-1
Minlikeeva, Albina N., Jo L. Freudenheim, Rikki A. Cannioto, J Brian Szender, Kevin H. Eng, Francesmary Modugno, Roberta B. Ness, et al. “History of hypertension, heart disease, and diabetes and ovarian cancer patient survival: evidence from the ovarian cancer association consortium.Cancer Causes Control 28, no. 5 (May 2017): 469–86. https://doi.org/10.1007/s10552-017-0867-1.
Minlikeeva AN, Freudenheim JL, Cannioto RA, Szender JB, Eng KH, Modugno F, et al. History of hypertension, heart disease, and diabetes and ovarian cancer patient survival: evidence from the ovarian cancer association consortium. Cancer Causes Control. 2017 May;28(5):469–86.
Minlikeeva, Albina N., et al. “History of hypertension, heart disease, and diabetes and ovarian cancer patient survival: evidence from the ovarian cancer association consortium.Cancer Causes Control, vol. 28, no. 5, May 2017, pp. 469–86. Pubmed, doi:10.1007/s10552-017-0867-1.
Minlikeeva AN, Freudenheim JL, Cannioto RA, Szender JB, Eng KH, Modugno F, Ness RB, LaMonte MJ, Friel G, Segal BH, Odunsi K, Mayor P, Zsiros E, Schmalfeldt B, Klapdor R, Dӧrk T, Hillemanns P, Kelemen LE, Kӧbel M, Steed H, de Fazio A, Australian Ovarian Cancer Study Group, Jordan SJ, Nagle CM, Risch HA, Rossing MA, Doherty JA, Goodman MT, Edwards R, Matsuo K, Mizuno M, Karlan BY, Kjær SK, Høgdall E, Jensen A, Schildkraut JM, Terry KL, Cramer DW, Bandera EV, Paddock LE, Kiemeney LA, Massuger LF, Kupryjanczyk J, Berchuck A, Chang-Claude J, Diergaarde B, Webb PM, Moysich KB, Ovarian Cancer Association Consortium. History of hypertension, heart disease, and diabetes and ovarian cancer patient survival: evidence from the ovarian cancer association consortium. Cancer Causes Control. 2017 May;28(5):469–486.
Journal cover image

Published In

Cancer Causes Control

DOI

EISSN

1573-7225

Publication Date

May 2017

Volume

28

Issue

5

Start / End Page

469 / 486

Location

Netherlands

Related Subject Headings

  • Survival Rate
  • Risk
  • Ovarian Neoplasms
  • Middle Aged
  • Insulin
  • Hypoglycemic Agents
  • Hypertension
  • Humans
  • Heart Diseases
  • Female