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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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