Kumar, Sanjeev

BACKGROUNDPreclinical evidence has suggested that sustained adrenergic activation can promote ovarian cancer growth and metastasis. The authors examined the impact of beta‐adrenergic blockade on the clinical outcome of women with epithelial ovarian, primary peritoneal, or fallopian tube cancers (collectively, epithelial ovarian cancer [EOC]).METHODSA multicenter review of 1425 women with histopathologically confirmed EOC was performed. Comparisons were made between patients with documented beta‐blocker use during chemotherapy and those without beta‐blocker use.RESULTSThe median age of patients in the current study was 63 years (range, 21‐93 years). The sample included 269 patients who received beta‐blockers. Of those, 193 (71.7%) were receiving beta‐1–adrenergic receptor selective agents, and the remaining patients were receiving nonselective beta antagonists. The primary indication for beta‐blocker use was hypertension but also included arrhythmia and postmyocardial infarction management. For patients receiving any beta‐blocker, the median overall survival (OS) was 47.8 months versus 42 months for nonusers (P =.04). The median OS based on beta‐blocker receptor selectivity was 94.9 months for those receiving nonselective beta‐blockers versus 38 months for those receiving beta‐1–adrenergic receptor selective agents (P<.001). Hypertension was associated with decreased OS compared with no hypertension across all groups. However, even among patients with hypertension, a longer median OS was observed among users of a nonselective beta‐blocker compared with nonusers (38.2 months vs 90 months; P<.001).CONCLUSIONSUse of nonselective beta‐blockers in patients with EOC was associated with longer OS. These findings may have implications for new therapeutic approaches. Cancer 2015;121:3435–43. © 2015 American Cancer Society.

AbstractObjectivesThe objective of this study is to examine the impact of marital status on survival of patients with epithelial ovarian cancer (EOC).MethodsPatients with a diagnosis of EOC were identified from the Surveillance, Epidemiology, and End Results Program for the period 1988–2006 and divided into married and unmarried groups. Statistical analysis using Student's t‐test, Kaplan–Meier, and Cox regression proportional hazards was performed.ResultsIn 49,777 patients with EOC, 51.2% were married and 48.8% were unmarried. White women were likely to be married compared with African Americans (52.0% vs 32.4%, p < 0.05). Younger age (63.9% vs 43.4%, p < 0.001) and early stage disease (37.5% vs 33.8%, p < 0.001) were more prominent in married patients compared with unmarried patients. Staging lymphadenectomy was performed more frequently in married than unmarried patients (39.9% vs 29.8%, p < 0.001).Overall 5‐year survival was 45.0% for married patients and 33.1% for unmarried patients, p < 0.001. Married patients had a better survival compared with unmarried patients within each racial subgroup: 44.5% vs 33.3% for White women (p < 0.001), 36.9% vs 24.9% for African Americans (p < 0.001), and 53.7% vs 42.7% for others (p < 0.001), respectively. In a model that controlled for age, race, histology, stage, grade, and surgical treatment, married patients had a significantly improved survival compared with unmarried patients (HR 0.8, 95% CI 0.78–0.83, p < 0.001).ConclusionsIn this epidemiologic study, the social institution of marriage is associated with improved survival in women with ovarian cancer. Copyright © 2011 John Wiley & Sons, Ltd.