Common comorbidities such as hypertension, heart disease, and diabetes may contribute to a woman’s prognosis after being diagnosed with ovarian cancer, according to a study published in Cancer Causes Control (2017;28[5]:469-486).
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Ovarian cancer is generally associated with poor survival. A better understanding of factors related to ovarian cancer prognosis could be important to optimizing treatment. Previously diagnosed comorbidities, medication to treat those conditions, and their relation to an ovarian cancer prognosis has yet to be fully researched.
Albina Minlikeeva, PhD, MPH, Roswell Park’s Department of Cancer Prevention and Control, and colleagues examined the associations between a history of hypertension, heart disease, diabetes, and medications to treat such conditions with overall survival and progression-free survival among patients with invasive epithelial ovarian carcinoma. Researchers pooled data form 15 studies participating in the Ovarian Cancer Association Consortium, involving patients with a history of diabetes (n = 7674), hypertension (n = 6482 patients), and heart disease (n = 4252 patients).
Researchers found that a history of diabetes was associated with an increased risk of death from ovarian cancer (HR, 1.12; 95% CI, 1.01-1.25). According to researchers, a possible driver of this correlation is hyperinsulinemia – a common comorbidity among older patients with diabetes – which leads to certain pathways being activated that promote tumor cell proliferation. Additionally, hyperglycemia may promote tumor growth by providing glucose as a source of energy to the cancer cells.
“This finding is particularly important in the context of a growing number of individuals with diabetes,” said Dr Minlikeeva in a press release (April 28, 2017).
On the contrary, no significant mortality associations were observed for hypertension (HR, 0.95; 95% CI, 0.88-1.02) or heart disease (HR, 1.05; 95% CI, 0.87-1.27). Researchers found that these conditions – along with the medications taken for these conditions – serve different roles in ovarian cancer survival. Use of beta blockers, oral antidiabetic medication, and insulin were associated with increased mortality, whereas use of diuretics was inversely associated with mortality.
Researchers concluded that an individual’s entire clinical profile may influence ovarian cancer survival and will provide future counsel regarding treatment options. Further research is needed in the preclinical and clinical setting to validate these findings. – Zachary Bessette
