Katharine K Brieger1, Siri Peterson1, Alice W Lee2, Bhramar Mukherjee3, Kelly M Bakulski1, Aliya Alimujiang1, Hoda Anton-Culver4, Michael S Anglesio5, Elisa V Bandera6, Andrew Berchuck7, David D L Bowtell8, Georgia Chenevix-Trench9, Kathleen R Cho10, Daniel W Cramer11, Anna DeFazio12, Jennifer A Doherty13, Renée T Fortner14, Dale W Garsed8, Simon A Gayther15, Aleksandra Gentry-Maharaj16, Ellen L Goode17, Marc T Goodman18, Holly R Harris19, Estrid Høgdall20, David G Huntsman21, Hui Shen22, Allan Jensen23, Sharon E Johnatty9, Susan J Jordan24, Susanne K Kjaer25, Jolanta Kupryjanczyk26, Diether Lambrechts27, Karen McLean28, Usha Menon16, Francesmary Modugno29, Kirsten Moysich30, Roberta Ness31, Susan J Ramus32, Jean Richardson33, Harvey Risch34, Mary Anne Rossing19, Britton Trabert35, Nicolas Wentzensen35, Argyrios Ziogas4, Kathryn L Terry11, Anna H Wu36, Gillian E Hanley5, Paul Pharoah37, Penelope M Webb38, Malcolm C Pike39, Celeste Leigh Pearce40. 1. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA. 2. Department of Public Health, California State University Fullerton, Fullerton, CA, USA. 3. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA; Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA. 4. Department of Medicine, University of California Irvine, Irvine, CA, USA. 5. Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada. 6. Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA. 7. Division of Gynecologic Oncology, Duke University School of Medicine, Durham, NC, USA. 8. Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria, Australia. 9. Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia. 10. Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA. 11. Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA; Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. 12. Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Australia; Department of Gynaecological Oncology, Westmead Hospital, Westmead, New South Wales, Australia. 13. Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA. 14. Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. 15. Cedars Sinai Medical Center, Los Angeles, CA, USA. 16. MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, University College London, London, UK. 17. Department of Health Science Research, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA. 18. Samuel Oschin Comprehensive Cancer Institute, Cancer Prevention and Genetics Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Community and Population Health Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA. 19. Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA. 20. Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark. 21. Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, BC Cancer Research Centre, Vancouver, Canada. 22. Van Andel Research Institute (VARI), Grand Rapids, MI, USA. 23. Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark. 24. University of Queensland, School of Public Health, Brisbane, Australia; Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia. 25. Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 26. Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland. 27. Vesalius Research Center, VIB, Leuven, Belgium; Laboratory for Translational Genetics, Department of Oncology, University of Leuven, Leuven, Belgium. 28. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA. 29. Womens Cancer Research Center, Magee-Women's Research Institute and Hillman Cancer Center, Pittsburgh, PA, USA; Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, USA. 30. Division of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA. 31. School of Public Health, University of Texas Health Science Center at Houston (UTHealth), TX, USA. 32. School of Women's and Children's Health, Faculty of Medicine, University of NSW Sydney, Sydney, New South Wales, Australia; The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, New South Wales, Australia. 33. Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney. Sydney, New South Wales, Australia. 34. Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA. 35. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. 36. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. 37. Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK; Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. 38. University of Queensland, School of Public Health, Brisbane, Australia; Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia; Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, QLD 4006, Australia. 39. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 40. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA. Electronic address: lpearce@umich.edu.
Abstract
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.
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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Authors: Jelena Bešević; Marc J Gunter; Renée T Fortner; Konstantinos K Tsilidis; Elisabete Weiderpass; N Charlotte Onland-Moret; Laure Dossus; Anne Tjønneland; Louise Hansen; Kim Overvad; Sylvie Mesrine; Laura Baglietto; Françoise Clavel-Chapelon; Rudolf Kaaks; Krasimira Aleksandrova; Heiner Boeing; Antonia Trichopoulou; Pagona Lagiou; Christina Bamia; Giovanna Masala; Claudia Agnoli; Rosario Tumino; Fulvio Ricceri; Salvatore Panico; H Bas Bueno-de-Mesquita; Petra H Peeters; Mie Jareid; J Ramón Quirós; Eric J Duell; María-José Sánchez; Nerea Larrañaga; María-Dolores Chirlaque; Aurelio Barricarte; Joana A Dias; Emily Sonestedt; Annika Idahl; Eva Lundin; Nicholas J Wareham; Kay-Tee Khaw; Ruth C Travis; Sabina Rinaldi; Isabelle Romieu; Elio Riboli; Melissa A Merritt Journal: Br J Cancer Date: 2015-11-10 Impact factor: 7.640
Authors: Katharine K Brieger; Minh Tung Phung; Bhramar Mukherjee; Kelly M Bakulski; Hoda Anton-Culver; Elisa V Bandera; David D L Bowtell; Daniel W Cramer; Anna DeFazio; Jennifer A Doherty; Sian Fereday; Renée Turzanski Fortner; Aleksandra Gentry-Maharaj; Ellen L Goode; Marc T Goodman; Holly R Harris; Keitaro Matsuo; Usha Menon; Francesmary Modugno; Kirsten B Moysich; Bo Qin; Susan J Ramus; Harvey A Risch; Mary Anne Rossing; Joellen M Schildkraut; Britton Trabert; Robert A Vierkant; Stacey J Winham; Nicolas Wentzensen; Anna H Wu; Argyrios Ziogas; Lilah Khoja; Kathleen R Cho; Karen McLean; Jean Richardson; Bronwyn Grout; Anne Chase; Cindy McKinnon Deurloo; Kunle Odunsi; Brad H Nelson; James D Brenton; Kathryn L Terry; Paul D P Pharoah; Andrew Berchuck; Gillian E Hanley; Penelope M Webb; Malcolm C Pike; Celeste Leigh Pearce Journal: Cancer Epidemiol Biomarkers Prev Date: 2021-11-17 Impact factor: 4.090
Authors: Minh Tung Phung; Aliya Alimujiang; Andrew Berchuck; Hoda Anton-Culver; Joellen M Schildkraut; Elisa V Bandera; Jenny Chang-Claude; Anne Chase; Jennifer Anne Doherty; Bronwyn Grout; Marc T Goodman; Gillian E Hanley; Alice W Lee; Cindy McKinnon Deurloo; Usha Menon; Francesmary Modugno; Paul D P Pharoah; Malcolm C Pike; Jean Richardson; Harvey A Risch; Weiva Sieh; Kathryn L Terry; Penelope M Webb; Nicolas Wentzensen; Anna H Wu; Celeste Leigh Pearce Journal: Cancer Epidemiol Biomarkers Prev Date: 2022-04-01 Impact factor: 4.090
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