Multivariable analysis of association of beta-blocker use and survival in advanced ovarian cancer

Gonzalez, R.; Gockley, Allison; Melamed, Alexander; Sugrue, Ronan; Clark, Rachel M.; Carmen, Marcela G. del; Growdon, Whitfield B.; Berkowitz, Ross S.; Horowitz, Neil S.; Worley, Michael J.

doi:10.1016/j.ygyno.2020.03.012

Cited by 10 publications

(23 citation statements)

References 35 publications

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“…Of these, 18 were further excluded based on reasons listed in Figure 1 . Finally, six studies were included ( 20 – 25 ).…”

Section: Resultsmentioning

confidence: 99%

“…The characteristics of the included studies were summarized in Table 1 . One study was a pooled analysis of individual-level data from 12 Ovarian Cancer Association Consortium studies ( 23 ), four were retrospective cohort studies ( 20 , 22 , 24 , 25 ), and the other one was a prospective cohort study ( 21 ). Overall, 17,981 women with confirmed diagnosis of OC from Israel, USA, UK, Australia, and Denmark were included in these studies.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies included women with FIGO stages I–IV OC ( 20 , 22 – 24 ), while the other two studies included women with stages I–III ( 21 ) and IIIC–IV ( 25 ) OC, respectively. Aspirin users were validated by prescription records in five studies ( 20 – 22 , 24 , 25 ), and by self-report questionnaires in one study ( 23 ). Moreover, post-diagnostic use of aspirin was analyzed for the included studies, except for one study in which pre-diagnostic use of aspirin was analyzed ( 23 ).…”

Section: Resultsmentioning

confidence: 99%

“…Both retrospective and prospective cohort studies were included. Moreover, aspirin use was validated by pharmacy records in five of the included studies ( 20 – 22 , 24 , 25 ), which were less biased than self-reported use in questionnaires. Different from the previous pooled-analysis, we performed multiple stratified analyses to evaluate whether the association could be affected by factors such as the timing of aspirin use, dose of aspirin, age of the women, and the clinical stages of the cancer.…”

Section: Discussionmentioning

confidence: 99%

“…However, uncertainty remains regarding the influence of aspirin use on mortality in women with OC, and previous observational studies evaluating this association showed inconsistent results ( 19 ). Some studies suggested that aspirin use was associated with reduced mortality events in women with OC ( 20 – 22 ), while others did not ( 23 – 25 ). In this study, we performed a meta-analysis to systematically evaluate the influence of aspirin use on mortality in women with OC.…”

Section: Introductionmentioning

confidence: 99%

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Aspirin Use and Mortality in Women With Ovarian Cancer: A Meta-Analysis

et al. 2021

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BackgroundAspirin use has been suggested to reduce the incidence of ovarian cancer (OC) in women. However, previous studies regarding the association between aspirin use and mortality in women with OC showed inconsistent results. We aimed to evaluate the association between aspirin use and mortality in women with OC in a meta-analysis.MethodsRelevant cohort studies were obtained via search of PubMed, Cochrane’s Library, and Embase databases from inception to May 3, 2020. A random-effect model, which incorporates the potential heterogeneity among the included studies, was used to pool the results. Predefined stratified analyses were applied to evaluate the potential study characteristics on the outcome, including the timing of aspirin use, dose of aspirin, age of the women, and the clinical stages of the cancer. Sensitivity analysis by omitting one study at a time was used to assess the stability of the results.ResultsSix cohort studies including 17,981 women with OC were included. Pooled results showed that aspirin use had no statistically significant association with mortality in these patients (adjusted risk ratio [RR]: 0.85, 95% confidence interval [CI]: 0.70 to 1.02, p = 0.08; I2 = 69%). The results were similar for OC-specific mortality (RR: 0.85, 95% CI: 0.57 to 1.26, p = 0.41) and all-cause mortality (RR: 0.78, 95% CI: 0.55 to 1.11, p = 0.17). Stratified analyses suggested that aspirin use had no statistically significant association with mortality risk in OC regardless the timing of aspirin use, dose of aspirin, age of the women, or the clinical stages of the cancer. Funnel plots suggested potential risk of publication bias (p all > 0.05). However, further “trim-and-fill” analysis incorporating hypothesized unpolished studies to achieve symmetrical funnel plots showed similar results of the meta-analysis (RR: 0.91, 95% CI: 0.74 to 1.13, p = 0.39).ConclusionsCurrent evidence from observational studies indicated that aspirin use had no statistically significant association with mortality in women with OC.

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“…Of these, 18 were further excluded based on reasons listed in Figure 1 . Finally, six studies were included ( 20 – 25 ).…”

Section: Resultsmentioning

confidence: 99%