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Abstract:
Reproductive and hormonal factors in relation to survival and platinum resistance among ovarian cancer cases : British Journal of Cancer
Background:
Ovarian cancer survival
is poor, particularly for platinum-resistant cases. The previous
literature on pre-diagnostic reproductive factors and ovarian cancer
survival has been mixed. Therefore, we evaluated pre-diagnostic
reproductive and hormonal factors with overall survival and,
additionally, platinum-chemotherapy resistance.
Methods:
We
followed 1649 invasive epithelial ovarian cancer cases who were
enrolled between 1992 and 2008 for overall mortality within the New
England Case-Control Study and abstracted chemotherapy data on a subset
(n=449). We assessed pre-diagnostic reproductive
and hormonal factors during in-person interviews. We calculated hazard
ratios (HRs) using Cox-proportional hazards models.
Results:
We
observed 911 all-cause deaths among 1649 ovarian cancer cases.
Self-reported endometriosis and longer duration of hormone therapy use
were associated with improved survival (HR: 0.72; 95% confidence interval (CI): 0.54–0.94 and HR, 5 years vs never: 0.70; 95% CI: 0.55–0.90, respectively). Older age at menopause and menarche were associated with worse survival (HR, 50 vs >50 years: 1.23; 95% CI: 1.03–1.46 and HR, 13 vs <13 years: 1.24; 95%
CI: 1.06–1.44, respectively). We observed no association between oral
contraceptive use, parity and tubal ligation, and overall survival. No
significant associations were observed for any of the reproductive and
hormonal factors and platinum resistance.
Conclusions:
These
results suggest that pre-diagnostic exposures such as endometriosis and
HT use may influence overall survival among ovarian cancer patients.
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