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Gynecologic Oncology - Impact of beta blockers on epithelial ovarian cancer survival
Highlights
►
We predict that beta blocker use correlates with improved outcome in
ovarian cancer.
► We retrospectively evaluated the association between beta blocker use and survival.
► Beta blocker use was associated with improved progression-free and overall survival and was an independent positive prognostic factor.
► We retrospectively evaluated the association between beta blocker use and survival.
► Beta blocker use was associated with improved progression-free and overall survival and was an independent positive prognostic factor.
Abstract
Objective
Stress
may promote ovarian cancer progression through mechanisms including
autonomic nervous system mediators such as norepinephrine and
epinephrine. Beta blockers, used to treat hypertension, block production
of these adrenergic hormones, and have been associated with prolonged
survival in several malignancies. We sought to determine the association
between beta blocker use and epithelial ovarian cancer (EOC) disease
progression and survival.
Methods
We
performed an institutional retrospective review of patients with EOC
treated between 1996 and 2006. Patients underwent cytoreductive surgery
followed by platinum-based chemotherapy. Women were considered beta
blocker users if these medications were documented on at least two
records more than 6 months apart. Statistical tests included Fisher's
exact, Kaplan–Meier, and Cox regression analyses.
Results
248
met inclusion criteria. 68 patients used antihypertensives, and 23 used
beta blockers. Median progression-free survival for beta blocker users
was 27 months, compared with 17 months for non-users (p = 0.05).
Similarly, overall disease-specific survival was longer for beta
blocker users (56 months) compared with non-users (48 months, p = 0.02,
hazard ratio = 0.56). Multivariate analysis identified beta blocker use
as an independent positive prognostic factor, after controlling for
age, stage, grade, and cytoreduction status (p = 0.03). Overall
survival remained longer for beta blocker users (56 months) when
compared with hypertensive patients on other medications (34 months) and
patients without hypertension (51 months) (p = 0.007).
Conclusions
In
this cohort of patients with EOC, beta blocker use was associated with a
54% reduced chance of death compared with that of non-users.
Highlights
►
We predict that beta blocker use correlates with improved outcome in
ovarian cancer.
► We retrospectively evaluated the association between beta blocker use and survival.
► Beta blocker use was associated with improved progression-free and overall survival and was an independent positive prognostic factor.
► We retrospectively evaluated the association between beta blocker use and survival.
► Beta blocker use was associated with improved progression-free and overall survival and was an independent positive prognostic factor.
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