High Prediagnosis Inflammation-Related Risk Score Associated with Decreased Ovarian Cancer Survival.
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Brieger Katharine K, Phung Minh Tung, Mukherjee Bhramar, Bakulski Kelly M, Anton-Culver Hoda, Bandera Elisa V, Bowtell David D L, Cramer Daniel W, DeFazio Anna, Doherty Jennifer A, Fereday Sian, Fortner Renée Turzanski, Gentry-Maharaj Aleksandra, Goode Ellen L, Goodman Marc T, Harris Holly R, Matsuo Keitaro, Menon Usha, Modugno Francesmary, Moysich Kirsten B, Qin Bo, Ramus Susan J, Risch Harvey A, Rossing Mary Anne, Schildkraut Joellen M, Trabert Britton, Vierkant Robert A, Winham Stacey J, Wentzensen Nicolas, Wu Anna H, Ziogas Argyrios, Khoja Lilah, Cho Kathleen R, McLean Karen, Richardson Jean, Grout Bronwyn, Chase Anne, Deurloo Cindy McKinnon, Odunsi Kunle, Nelson Brad H, Brenton James D, Terry Kathryn L, Pharoah Paul D P, Berchuck Andrew, Hanley Gillian E, Webb Penelope M, Pike Malcolm C, Pearce Celeste Leigh, Ovarian Cancer Association Consortium
Аннотация
METHODS: This analysis used pooled data on 8,147 women with invasive epithelial ovarian cancer from the Ovarian Cancer Association Consortium. The prediagnosis inflammation-related exposures of interest included alcohol use; aspirin use; other nonsteroidal anti-inflammatory drug use; body mass index; environmental tobacco smoke exposure; history of pelvic inflammatory disease, polycystic ovarian syndrome, and endometriosis; menopausal hormone therapy use; physical inactivity; smoking status; and talc use. Using Cox proportional hazards models, the relationship between each exposure and survival was assessed in 50% of the data. A weighted inflammation-related risk score (IRRS) was developed, and its association with survival was assessed using Cox proportional hazards models in the remaining 50% of the data.
RESULTS: There was a statistically significant trend of increasing risk of death per quartile of the IRRS [HR = 1.09; 95% confidence interval (CI), 1.03-1.14]. Women in the upper quartile of the IRRS had a 31% higher death rate compared with the lowest quartile (95% CI, 1.11-1.54).
CONCLUSIONS: A higher prediagnosis IRRS was associated with an increased mortality risk after an ovarian cancer diagnosis. Further investigation is warranted to evaluate whether postdiagnosis exposures are also associated with survival.
IMPACT: Given that pre- and postdiagnosis exposures are often correlated and many are modifiable, our study results can ultimately motivate the development of behavioral recommendations to enhance survival among patients with ovarian cancer.