Department of Obstetrics and Gynecology, Hallym University Sacred Heart Hospital, Anyang, Korea.
Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
J Gynecol Oncol. 2018 Nov;29(6):e82. doi: 10.3802/jgo.2018.29.e82.
The impact of beta blockers (BBs) on survival outcomes in ovarian cancer was investigated.
By using Korean National Health Insurance Service Data, Cox proportional hazards regression was performed to analyze hazard ratios (HRs) with 95% confidence intervals (CIs) adjusting for confounding factors.
Among 866 eligible patients, 206 (23.8%) were BB users and 660 (76.2%) were non-users. Among the 206 BB users, 151 (73.3%) were non-selective beta blocker (NSBB) users and 105 (51.0%) were selective beta blocker (SBB) users. BB use in patients aged ≥60 years, longer duration use (≥1 year), in patients with Charlson Comorbidity Index (CCI) ≥3, and in cardiovascular disease including hypertension was associated with better survival outcome. These findings were observed in both NSBB and SBB. When duration of medication was analyzed based on number of days, NSBB (≥180 days) was associated with improved overall survival (OS) with a relatively shorter period of use compared to SBB (≥720 days). In multivariate Cox proportional hazards model, longer duration of BB medication (≥1 year) was an independent favorable prognostic factor for both OS and disease-specific survival in ovarian cancer patients.
In our nationwide population-based cohort study, BB use was associated with better survival outcomes in ovarian cancer in cases of long term duration of use, in older patients, and in cardiovascular and/or other underlying disease (CCI ≥3).
研究β受体阻滞剂(BBs)对卵巢癌患者生存结局的影响。
利用韩国国家健康保险服务数据,采用 Cox 比例风险回归分析,调整混杂因素后分析风险比(HR)及其 95%置信区间(CI)。
在 866 名符合条件的患者中,206 名(23.8%)为 BB 使用者,660 名(76.2%)为非使用者。在 206 名 BB 使用者中,151 名(73.3%)为非选择性β受体阻滞剂(NSBB)使用者,105 名(51.0%)为选择性β受体阻滞剂(SBB)使用者。≥60 岁的患者、用药时间≥1 年、Charlson 合并症指数(CCI)≥3 以及心血管疾病(包括高血压)的 BB 使用与更好的生存结局相关。这些发现既存在于 NSBB 中,也存在于 SBB 中。当根据用药天数分析用药持续时间时,与 SBB(≥720 天)相比,NSBB(≥180 天)的使用时间相对较短,与总生存期(OS)的改善相关。在多变量 Cox 比例风险模型中,BB 用药持续时间≥1 年是卵巢癌患者 OS 和疾病特异性生存的独立有利预后因素。
在我们的全国性基于人群的队列研究中,长期使用 BB 与卵巢癌患者的生存结局改善相关,在老年患者以及心血管和/或其他基础疾病(CCI≥3)的患者中更为明显。