Reproductive and hormonal factors in relation to survival and platinum resistance among ovarian cancer cases

Shafrir, Amy; Babić, Ana; Tamimi, Rulla M.; Rosner, Bernard; Tworoger, Shelley S.; Terry, Kathryn L.

doi:10.1038/bjc.2016.316

Cited by 19 publications

(35 citation statements)

References 33 publications

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“…In the current study, parity per se (but not increasing parity or age at first birth) was associated with better prognosis in contrast to most previous studies that have generally shown no significant association between parity and survival (Besevic et al , 2015; Poole et al , 2016; Shafrir et al , 2016). Recent observational studies have shown that parity is associated with decreased risk of type I tumours (i.e., low-grade subtypes; Fortner et al , 2015) as well as with less aggressive subtypes (i.e., survived ⩾3 years; Poole et al , 2013).…”

Section: Discussioncontrasting

confidence: 99%

“…The authors of the review concluded that overall the data were sparse, and whereas reproductive or hormonal factors were likely not strong predictors of outcome, body size was among the most studied and represented a lifestyle factor that may favourably influence prognosis. Since this review, one additional work evaluated the association of reproductive and hormonal factors on survival, in data from the New England Case-Control Study of Ovarian Cancer that included prediagnostic information on 1649 ovarian cancer patients and 911 all-cause deaths and reported improved survival for endometriosis and for HRT use (Shafrir et al , 2016). …”

Section: Discussionmentioning

confidence: 99%

“…Eight published observational studies have examined HRT use before diagnosis and survival. These studies ranged in size from 72 to 1649 patients, with only 3 studies adjusting for residual disease in their analysis (Poole et al , 2016; Shafrir et al , 2016). Findings have been inconclusive.…”

Section: Discussionmentioning

confidence: 99%

“…Findings have been inconclusive. In the largest of these studies, Shafrir et al (2016) reported a significant survival advantage among women with ⩾5 years of HRT use before diagnosis (HR for ⩾5 years vs never use=0.79; 95% CI 0.55–0.90). The authors did not distinguish between types of hormonal preparations.…”

Section: Discussionmentioning

confidence: 99%

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Epidemiologic factors that predict long-term survival following a diagnosis of epithelial ovarian cancer

et al. 2017

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Background:Various epidemiologic factors have been shown to influence the risk of ovarian cancer development. Given the high fatality associated with this disease, it is of interest to evaluate the association of prediagnostic hormonal, reproductive, and lifestyle exposures with ovarian cancer-specific survival.Methods:We included 1421 patients with invasive epithelial ovarian cancer diagnosed in Ontario, Canada. Clinical information was obtained from medical records and prediagnostic exposure information was collected by telephone interview. Survival status was determined by linkage to the Ontario Cancer Registry. Proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for ovarian cancer-specific mortality associated with each exposure. Analyses were stratified by histologic subtype to further investigate the associations of risk factors on ovarian cancer-specific mortality.Results:After a mean follow-up of 9.48 years (range 0.59–20.32 years), 655 (46%) women had died of ovarian cancer. Parity (ever) was associated with a significant 29% decreased mortality risk compared with nulliparity (HR=0.71; 95% CI 0.54–0.93; P=0.01). There was a borderline significant association between ever use of oestrogen-containing hormone replacement therapy (HRT) and mortality (HR=0.79; 95% CI 0.62–1.01; P=0.06). A history of cigarette smoking was associated with a significant 25% increased risk of death compared with never smoking (HR=1.25; 95% CI 1.01–1.54; P=0.04). Women with a greater cumulative number of ovulatory cycles had a significantly decreased risk of ovarian cancer-specific death (HR=0.63; 95% CI 0.43–0.94; P=0.02). Increasing BMI (kg m−2) 5 years before diagnosis was associated with an increased risk of death (HR=1.17; 95% CI 1.07–1.28; P=0.0007). Other hormonal or lifestyle factors were not significantly associated with ovarian cancer-specific mortality.Conclusions:Parity, ovulatory cycles, smoking, and BMI may affect survival following the diagnosis of ovarian cancer. Whether or not oestrogen-containing HRT use is beneficial for survival requires further evaluation.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Epidemiologic factors that predict long-term survival following a diagnosis of epithelial ovarian cancer

et al. 2017

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“…Although age at menarche was not significantly related to the risk of ovarian cancer overall, later age at menarche was associated with worse EOC survival. 29,30 It is still unclear whether an older age of menarche is associated with EOC considering the lifetime ovulation factor in OC etiology. Further studies are necessary to confirm possible interactions in larger independent populations.…”

Section: Discussionmentioning

confidence: 99%

Association of a common variant of SYNPO2 gene with increased risk of serous epithelial ovarian cancer

Zhang

Ding

et al. 2017

Tumour Biol.

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In China, the majority of ovarian cancer patients (80%-90%) are women who are diagnosed with epithelial ovarian cancer. The SYNPO2 gene has recently been reported to be associated with epithelial ovarian cancer in Europeans. To investigate the association of common variants of SYNPO2 gene with epithelial ovarian cancer in Han Chinese individuals, we designed a case-control study with 719 epithelial ovarian cancer patients and 1568 unrelated healthy controls of Han Chinese descent. A total of 49 tagging single-nucleotide polymorphisms were genotyped; single-single-nucleotide polymorphism association, imputation, and haplotypic association analyses were performed. The single-nucleotide polymorphism rs17329882 was found to be strongly associated with serous epithelial ovarian cancer and with ages ≤49 years, consistent with the pre-menopausal status of analyzed epithelial ovarian cancer cases. Odds ratios and 95% confidence intervals provided evidence of the risk effects of the C allele of the single-nucleotide polymorphism on epithelial ovarian cancer. Imputation analyses also confirmed the results with a similar pattern. Additionally, haplotype analyses indicated that the haplotype block that contained rs17329882 was significantly associated with epithelial ovarian cancer risk, specifically with the serous epithelial ovarian cancer subtype. In conclusion, our results show that SYNPO2 gene plays an important role in the etiology of epithelial ovarian cancer, suggesting that this gene may be a potential genetic modifier for developing epithelial ovarian cancer.

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Parity is associated with better prognosis in ovarian germ cell tumors, but not in other ovarian cancer subtypes

Sköld

Koliadi

Enblad

et al. 2021

Intl Journal of Cancer

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Ovarian cancer is influenced by reproductive factors, with a reduced risk of epithelial ovarian cancer in parous women. Nonepithelial ovarian cancer frequently affects young women and often precedes or occurs during the childbearing years. However, the impact of reproductive factors on ovarian cancer survival remains unclear: in epithelial ovarian cancer, data are conflicting, and subtype-specific associations have not been examined, and in nonepithelial ovarian cancer, it has not been studied. Using Swedish registers, we evaluated associations between women's reproductive history and cancer-specific mortality by subtype of epithelial and nonepithelial ovarian cancer in 3791 women born 1953 and later, diagnosed from 1990 to 2018. Hazard ratios (HRs) with 95% confidence intervals (95% CIs) were calculated using Cox-proportional hazard models. Parity was associated with a 78% decreased risk of cause-specific mortality in 243 women with germ cell tumors (GCTs) (parous vs nulliparous, adjusted for age at diagnosis: HR: 0.22 [95% CI 0.07-0.62]), with a decreased risk with increasing number of births (per birth: HR: 0.60 [95% CI 0.38-0.95]). We found no evidence of associations between parity and cause-specific mortality among the 334 patients with sex-cord stromal tumors, nor among the 3214 patients with epithelial ovarian cancer; neither overall, nor by subtype.In conclusion, in our large, population-based study, parity was associated with a clearly better prognosis in GCTs but not in the other ovarian cancer subtypes. Future research on how hormone exposure impacts GCT development may lead to a better understanding of mechanisms affecting survival.

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Reproductive and hormonal factors in relation to survival and platinum resistance among ovarian cancer cases

Cited by 19 publications

References 33 publications

Epidemiologic factors that predict long-term survival following a diagnosis of epithelial ovarian cancer

Epidemiologic factors that predict long-term survival following a diagnosis of epithelial ovarian cancer

Association of a common variant of SYNPO2 gene with increased risk of serous epithelial ovarian cancer

Parity is associated with better prognosis in ovarian germ cell tumors, but not in other ovarian cancer subtypes

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