scholarly journals 647Use of menopausal hormone therapy before and after ovarian cancer diagnosis and ovarian cancer survival

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Nina Renhua Na ◽  
Susan J Jordan ◽  
Andreas Obermair ◽  
Penelope M Webb ◽  
Keyword(s):  
Ovarian Cancer ◽  
Propensity Score ◽  
Hormone Therapy ◽  
Cancer Survival ◽  
Menopausal Hormone Therapy ◽  
Cancer Prognosis ◽  
Confounding By Indication ◽  
Menopausal Women ◽  
Post Menopausal ◽  
Ovarian Cancer Survival

Abstract Background Menopausal hormone therapy (MHT) use before ovarian cancer (OvCa) diagnosis has been suggested to improve survival but data on type, duration and use after treatment for OvCa are scarce. Methods We investigated MHT use and OvCa survival among participants with newly diagnosed OvCA in the Ovarian cancer Prognosis And Lifestyle (OPAL) Study. Analysis of pre-diagnosis use was restricted to 661 post-menopausal women and analysis of post-diagnosis use included 254 women aged ≤55-years. We used multivariable Cox proportional hazards regression to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between MHT and OvCa-specific survival. We used propensity score-based approaches to account for potential bias due to confounding by indication. Results Approximately 14% of post-menopausal women were current/recent users of oestrogen-only (7%) or oestrogen-progestin/unknown MHT (E-P=7%) at the time of diagnosis. In the pre-diagnosis analysis, E-P use was associated with better survival (HR = 0.60, 95%CI=0.37-0.98; HR = 0.93, 95%CI=0.79-1.09 per 5-years/use). The association between oestrogen-only MHT and survival was weaker and non-significant (HR = 0.74, 95%CI=0.47-1.16). Among women ≤55-years at diagnosis, the HR was 0.91 (95%CI=0.50-1.67) for new use after diagnosis regardless of type; and 0.89 (95%CI 0.51-1.54) for any use post-diagnosis compared to never users. Propensity-score-based methods showed similar estimates. Conclusions Pre-diagnosis MHT use is associated with better ovarian cancer survival. Post-diagnosis MHT use might also improve survival for women younger than 55-years, even after accounting for bias due to confounding by indication. Key messages Menopausal hormone therapy may be considered to manage menopausal symptoms in women with ovarian cancer.

Vaginal hysterectomy with or without bilateral salpingo-oophorectomy may be an alternative treatment for endometrial cancer patients with medical co-morbidities precluding standard surgical procedures: a systematic review

2019 ◽  
Vol 29 (2) ◽  
pp. 299-304 ◽  
Author(s):  
Arnold-Jan Kruse ◽  
Henk G ter Brugge ◽  
Harm H de Haan ◽  
Hugo W Van Eyndhoven ◽  
Hans W Nijman
Keyword(s):  
Ovarian Cancer ◽  
Endometrial Cancer ◽  
Vaginal Hysterectomy ◽  
Cancer Survival ◽  
Survival Rates ◽  
Survival Outcomes ◽  
Ovarian Malignancy ◽  
Post Menopausal ◽  
Ovarian Cancer Survival ◽  
Overall Survival Rates

ObjectiveVaginal hysterectomy with bilateral salpingo-oophorectomy may be an alternative strategy for patients with low-risk endometrial cancer and medical co-morbidities precluding laparoscopic or abdominal procedures. The current study evaluates the prevalence of co-existent ovarian malignancy in patients with endometrial cancer and the influence of bilateral salpingo-oophorectomy on survival outcomes in these patients.MethodsMedline and EMBASE were searched for studies published between January 1, 2000 and November 20, 2017 that investigated (1) the prevalence of co-existing ovarian malignancy (either metastases or primary synchronous ovarian cancer in women with endometrial cancer, and (2) the influence of bilateral salpingo-oophorectomy on recurrence and/or survival rates.ResultsOf the pre-menopausal and post-menopausal patients (n=6059), 373 were identified with metastases and 106 were identified with primary synchronous ovarian cancer. Of the post-menopausal patients (n=6016), 362 were identified with metastases and 44 were identified with primary synchronous ovarian cancer. Survival outcomes did not differ for pre-menopausal patients with endometrial cancer with and without bilateral salpingo-oophorectomy (5-year overall survival rates were 89–94.5% and 86–97.8%, respectively).ConclusionBilateral salpingo-oophorectomy during vaginal hysterectomy seems to have a limited impact on disease outcome in patients with endometrial cancer. These results support the view that vaginal hysterectomy alone or with bilateral salpingo-oophorectomy may be an option for patients with endometrial cancer who are not ideal surgical candidates.

scholarly journals 1466Vitamin D status before, during and after treatment and ovarian cancer survival

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Tanya Ross ◽  
Penny Webb ◽  
Rachel Neale
Keyword(s):  
Ovarian Cancer ◽  
Vitamin D ◽  
Survival Data ◽  
Cancer Survival ◽  
Cox Regression ◽  
Primary Treatment ◽  
Parametric Models ◽  
Cancer Prognosis ◽  
Ovarian Cancer Survival ◽  
Ovarian Cancer Prognosis

Abstract Background Previous work found higher serum 25-hydroxyvitamin D (25(OH)D) [circulating form of vitamin D] concentrations at diagnosis were associated with longer survival in patients with ovarian cancer (OvCa). There was no evidence for an association with 25(OH)D after primary treatment, but power was limited. Our aim was to reassess this association in a larger sample, including measures collected during treatment and using techniques to deseasonalise 25(OH)D. Methods Participants were diagnosed between 2002-2006 and 2012-2015 from the Australian Ovarian Cancer Study (AOCS) and the Ovarian Cancer, Prognosis and Lifestyle (OPAL) study, respectively. 25(OH)D concentrations were available for 676 at diagnosis (AOCS), 805 during treatment (AOCS:208; OPAL:597) and 861 after completion of primary treatment and before recurrence (AOCS:342; OPAL:519); 1006 AOCS samples were included in the previous analysis. Sociodemographic, diet and lifestyle data came from questionnaires self-completed at recruitment, and clinical/survival data from medical records, supplemented with National Death Index linkage. We will use Cox regression and non-parametric models to examine associations with survival. Results Median 25(OH)D concentrations were lowest during treatment, intermediate at diagnosis and highest after treatment (AOCS 51, 64, and 71 nmol/L, respectively). 5-year survival was 50% in AOCS and 59% in OPAL. Updated survival results will be presented. Conclusions If the association is confirmed in this updated analysis, then increasing vitamin D concentrations may provide a way to improve survival following OvCa. Key messages Higher circulating vitamin D concentrations may improve survival in OvCa.

scholarly journals Risk of Breast Cancer by Type of Menopausal Hormone Therapy: a Case-Control Study among Post-Menopausal Women in France

PLoS ONE ◽  
2013 ◽  
Vol 8 (11) ◽  
pp. e78016 ◽  
Author(s):  
Emilie Cordina-Duverger ◽  
Thérèse Truong ◽  
Antoinette Anger ◽  
Marie Sanchez ◽  
Patrick Arveux ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Therapy ◽  
Case Control Study ◽  
Case Control ◽  
Menopausal Hormone Therapy ◽  
Menopausal Women ◽  
Post Menopausal ◽  
Control Study

scholarly journals Effect of Estradiol as a Continuous Variable on Breast Cancer Survival by Menopausal Status: A Cohort Study in China

2021 ◽  
Author(s):  
Junxian Li ◽  
Chenyang Li ◽  
Ziwei Feng ◽  
Luyang Liu ◽  
Liwen Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survival ◽  
Menopausal Status ◽  
Continuous Variable ◽  
Breast Cancer Survival ◽  
Cancer Prognosis ◽  
Breast Cancer Patients ◽  
Increased Risk ◽  
Menopausal Women ◽  
Post Menopausal

Abstract BackgroundHigh levels of circulating estradiol (E2) are associated with increased risk of breast cancer, whereas its relationship with breast cancer prognosis is still unclear. We studied the effect of E2 concentration on breast cancer survival among pre- menopausal and post- menopausal patients in China.MethodsWe evaluated this association among 8766 breast cancer cases diagnosed between 2005 and 2017 from the Tianjin Breast Cancer Cases Cohort. Levels of serum E2 were measured in pre-menopausal and post-menopausal women. Multivariable-adjusted Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) between quartile of E2 levels and overall survival (OS) and progression-free survival (PFS) of breast cancer. The penalized spline was then used to test for non-linear relationships between E2 (continuous variable) and survival endpoints.ResultsA total of 612 deaths and 982 progressions occurred over follow-up through 2017. Compared to women in the quartile 3, the highest quartile of E2 was associated with reduced risk of both PFS in pre-menopausal women (HR=1.79, 95% CI: 1.17-2.75, P=0.008) and OS in post-menopausal women (HR=1.35, 95% CI: 1.04-1.74, P=0.023). OS and PFS in pre-menopausal women exhibited a nonlinear relation (“L-shaped” and “U-shaped”, respectively) with E2 levels. However, there was a linear relationship in post-menopausal women, among whom increasing E2 was associated with escalating risks of death and progression. Moreover, patients with estrogen receptor-negative (ER-negative) breast cancer showed a “U-shaped” relationship with OS and PFS in pre-menopausal women.ConclusionsPre-menopausal breast cancer patients have a plateau stage of prognosis at the intermediate concentrations of E2, whereas post-menopausal patients have no apparent threshold, and ER status may have an impact on this relationship.

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