TY - JOUR
T1 - Menopausal hormone therapy prior to the diagnosis of ovarian cancer is associated with improved survival
AU - for the Ovarian Cancer Association Consortium
AU - Brieger, Katharine K.
AU - Peterson, Siri
AU - Lee, Alice W.
AU - Mukherjee, Bhramar
AU - Bakulski, Kelly M.
AU - Alimujiang, Aliya
AU - Anton-Culver, Hoda
AU - Anglesio, Michael S.
AU - Bandera, Elisa V.
AU - Berchuck, Andrew
AU - Bowtell, David D.L.
AU - Chenevix-Trench, Georgia
AU - Cho, Kathleen R.
AU - Cramer, Daniel W.
AU - DeFazio, Anna
AU - Doherty, Jennifer A.
AU - Fortner, Renée T.
AU - Garsed, Dale W.
AU - Gayther, Simon A.
AU - Gentry-Maharaj, Aleksandra
AU - Goode, Ellen L.
AU - Goodman, Marc T.
AU - Harris, Holly R.
AU - Høgdall, Estrid
AU - Huntsman, David G.
AU - Shen, Hui
AU - Jensen, Allan
AU - Johnatty, Sharon E.
AU - Jordan, Susan J.
AU - Kjaer, Susanne K.
AU - Kupryjanczyk, Jolanta
AU - Lambrechts, Diether
AU - McLean, Karen
AU - Menon, Usha
AU - Modugno, Francesmary
AU - Moysich, Kirsten
AU - Ness, Roberta
AU - Ramus, Susan J.
AU - Richardson, Jean
AU - Risch, Harvey
AU - Rossing, Mary Anne
AU - Trabert, Britton
AU - Wentzensen, Nicolas
AU - Ziogas, Argyrios
AU - Terry, Kathryn L.
AU - Wu, Anna H.
AU - Hanley, Gillian E.
AU - Pharoah, Paul
AU - Webb, Penelope M.
AU - Pike, Malcolm C.
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/9
Y1 - 2020/9
N2 - Purpose: Prior studies of menopausal hormone therapy (MHT) and ovarian cancer survival have been limited by lack of hormone regimen detail and insufficient sample sizes. To address these limitations, a comprehensive analysis of 6419 post-menopausal women with pathologically confirmed ovarian carcinoma was conducted to examine the association between MHT use prior to diagnosis and survival. Methods: Data from 15 studies in the Ovarian Cancer Association Consortium were included. MHT use was examined by type (estrogen-only (ET) or estrogen+progestin (EPT)), duration, and recency of use relative to diagnosis. Cox proportional hazards models were used to estimate the association between hormone therapy use and survival. Logistic regression and mediation analysis was used to explore the relationship between MHT use and residual disease following debulking surgery. Results: Use of ET or EPT for at least five years prior to diagnosis was associated with better ovarian cancer survival (hazard ratio, 0.80; 95% CI, 0.74 to 0.87). Among women with advanced stage, high-grade serous carcinoma, those who used MHT were less likely to have any macroscopic residual disease at the time of primary debulking surgery (p for trend <0.01 for duration of MHT use). Residual disease mediated some (17%) of the relationship between MHT and survival. Conclusions: Pre-diagnosis MHT use for 5+ years was a favorable prognostic factor for women with ovarian cancer. This large study is consistent with prior smaller studies, and further work is needed to understand the underlying mechanism.
AB - Purpose: Prior studies of menopausal hormone therapy (MHT) and ovarian cancer survival have been limited by lack of hormone regimen detail and insufficient sample sizes. To address these limitations, a comprehensive analysis of 6419 post-menopausal women with pathologically confirmed ovarian carcinoma was conducted to examine the association between MHT use prior to diagnosis and survival. Methods: Data from 15 studies in the Ovarian Cancer Association Consortium were included. MHT use was examined by type (estrogen-only (ET) or estrogen+progestin (EPT)), duration, and recency of use relative to diagnosis. Cox proportional hazards models were used to estimate the association between hormone therapy use and survival. Logistic regression and mediation analysis was used to explore the relationship between MHT use and residual disease following debulking surgery. Results: Use of ET or EPT for at least five years prior to diagnosis was associated with better ovarian cancer survival (hazard ratio, 0.80; 95% CI, 0.74 to 0.87). Among women with advanced stage, high-grade serous carcinoma, those who used MHT were less likely to have any macroscopic residual disease at the time of primary debulking surgery (p for trend <0.01 for duration of MHT use). Residual disease mediated some (17%) of the relationship between MHT and survival. Conclusions: Pre-diagnosis MHT use for 5+ years was a favorable prognostic factor for women with ovarian cancer. This large study is consistent with prior smaller studies, and further work is needed to understand the underlying mechanism.
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U2 - 10.1016/j.ygyno.2020.06.481
DO - 10.1016/j.ygyno.2020.06.481
M3 - Article
C2 - 32641237
AN - SCOPUS:85087517386
SN - 0090-8258
VL - 158
SP - 702
EP - 709
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 3
ER -