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

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.

A novel six-gene signature for prognosis prediction in ovarian cancer

“…The traditional FIGO (2014) staging system is the dominant assessment criterion for estimating the treatment and outcome of OC patients. However, individuals in the same stage and receiving the same therapy, meet different prognoses [5,6]. Thus, the current staging system is inadequate, and it is urgent to seek more significant indicators to identify the high-risk population.…”

History of Comorbidities and Survival of Ovarian Cancer Patients, Results from the Ovarian Cancer Association Consortium

“…Previously we reported on the association between histories of hypertension, heart disease, and diabetes in relation to overall survival (OS) and progression-free survival (PFS) among ovarian cancer patients (7). In this study, using a large multi-national sample of studies participating in the Ovarian Cancer Association Consortium (OCAC), we explore the relationship between other selected common comorbidities and OS and PFS among women diagnosed with ovarian cancer.…”

Prognostic value of hypertension in patients with nasopharyngeal carcinoma treated with intensity-modulated radiation therapy

“…Similarly, Eytan DF et al [20] analysed the effect of hypertension on the survival of head and neck cancer patients and found a 7-19% increased risk in cancer mortality in those with hypertension compared with those without hypertension. However, the prognostic value of hypertension in ovarian cancer (Stocks T et al [9] and Minlikeeva AN et al [21]) and breast cancer (Schairer C et al [22] and Braithwaite1 D et al [23]) patients remains controversial. This may be due to differences in the biology and pathology of NPC vs. ovarian and breast cancers.…”