Ahmed Al-Niaimi1, Elizabeth L Dickson2, Cassandra Albertin3, Jennifer Karnowski4, Cassandra Niemi4, Ryan Spencer4, Mian M K Shahzad5, Shitanshu Uppal4, Sandeep Saha4, Laurel Rice4, Amy Mc Nally6. 1. Division of Gynecologic Oncology, Department of OBGYN, University of Wisconsin, Madison, WI, USA. Electronic address: alniaimi@wisc.edu. 2. Department of Gynecologic Oncology, Aurora Medical Group, Milwaukee, WI, USA. 3. Division of Gynecologic Oncology, Department of OBGYN, University of Minnesota, Minneapolis, MN, USA. 4. Division of Gynecologic Oncology, Department of OBGYN, University of Wisconsin, Madison, WI, USA. 5. Division of Gynecologic Oncology, Department of OBGYN, University of Wisconsin, Madison, WI, USA; Department of Gynecologic Oncology, Lee H. Moffitt Cancer Center, Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA. 6. Department of Gynecologic Oncology, Minnesota Oncology, Minneapolis, MN, USA.
Abstract
OBJECTIVE: To quantify the impact of perioperative β blocker use on survivalafter primary cytoreductive surgery for epithelial ovarian cancer. METHODS: We conducted a multi-center retrospective study of all women who underwent primary cytoreductive surgery for ovarian cancer (2000-2010). One institution had routinely used perioperative β blockers for patients "at risk" for coronary events. The other institution did not routinely use perioperative β blockers. Demographic, operative, and follow up data were collected. Cox proportional hazards models were used to assess the effect of β blockers on progression-free interval (PFI) as well as overall survival (OS). RESULTS: Out of 185 eligible patients, 70 received β blockers and 115 underwentcytoreductive surgery without perioperative β blockers. Both groups were similar in demographics. A history of hypertension was present more often in the β blocker group compared to the group that did not receive β blockers (22% and 6%, p=0.002). PFI in β blocker group was greater at 18.2 vs. 15.8months (p=0.66). The OS in the β blocker group was significantly higher at 44.2 vs. 39.3months (p=0.01). In multivariate analysis, perioperative β blocker use was associated with significant improvement in OS (HR 0.68 (0.46-0.99); p=0.046). CONCLUSION: Our study showed an association between perioperative β blocker use and longer overall survival in patients undergoing primary ovarian cancer cytoreductive surgery. A prospective randomized clinical trial in this population would further validate these results.
RCT Entities:
OBJECTIVE: To quantify the impact of perioperative β blocker use on survival after primary cytoreductive surgery for epithelial ovarian cancer. METHODS: We conducted a multi-center retrospective study of all women who underwent primary cytoreductive surgery for ovarian cancer (2000-2010). One institution had routinely used perioperative β blockers for patients "at risk" for coronary events. The other institution did not routinely use perioperative β blockers. Demographic, operative, and follow up data were collected. Cox proportional hazards models were used to assess the effect of β blockers on progression-free interval (PFI) as well as overall survival (OS). RESULTS: Out of 185 eligible patients, 70 received β blockers and 115 underwent cytoreductive surgery without perioperative β blockers. Both groups were similar in demographics. A history of hypertension was present more often in the β blocker group compared to the group that did not receive β blockers (22% and 6%, p=0.002). PFI in β blocker group was greater at 18.2 vs. 15.8months (p=0.66). The OS in the β blocker group was significantly higher at 44.2 vs. 39.3months (p=0.01). In multivariate analysis, perioperative β blocker use was associated with significant improvement in OS (HR 0.68 (0.46-0.99); p=0.046). CONCLUSION: Our study showed an association between perioperative β blocker use and longer overall survival in patients undergoing primary ovarian cancer cytoreductive surgery. A prospective randomized clinical trial in this population would further validate these results.
Authors: Lois M Ramondetta; Wei Hu; Premal H Thaker; Diana L Urbauer; Gary B Chisholm; Shannon N Westin; Yunjie Sun; Pedro T Ramirez; Nicole Fleming; Sunil K Sahai; Alpa M Nick; Jesusa M G Arevalo; Thomas Dizon; Robert L Coleman; Steve W Cole; Anil K Sood Journal: Gynecol Oncol Date: 2019-07-25 Impact factor: 5.482