[Effects of sociomedical risk factors on the progression of ovarian cancer].

INTRODUCTION

The potential prognostic influence of sociomedical risk factors probably on ovarian cancer patient prognosis has yet not been intensively investigated. This study was to determine whether the general psychologic constitution has an influence on patient survival after primäry surgery and in how far it correlates to sociobiologic factors.

METHOD: 695 long-term followed ovarian carcinoma patients were studied. The median follow-up was 4.8 years with a range of 63 days to 18.7 years. Tumor-associated death was recorded in 219 patients. The prognostic influence of sociomedical risk factor was determined by age and stage corrected survival analysis.

RESULTS

The variables "genetic or hereditary risk", "hormone replacement therapy" and "use of tobacco or alcohol" had no significant influence on survival. However, the variables "psychic disorders" and "parity" were found to be of strong prognostic influence, alone and in combination. Patients showing psychic disorders had a clearly worse prognosis (p < 0,001), as well as those of higher parity (p < 0,001).

DISCUSSION: This newly described link between patients' psychological constitution and course of disease suggests psychotherapeutic support to be helpful for ovarian carcinoma patients. Risk factors, furthermore, may have an opposite effect on both cancer incidence and prognosis. The latter is discussed on the background of an ovarian carcinogenesis threshold model.