The impact of perioperative β blocker use on patient outcomes after primary cytoreductive surgery in high-grade epithelial ovarian carcinoma

Gynecol Oncol. 2016 Dec;143(3):521-525. doi: 10.1016/j.ygyno.2016.09.019. Epub 2016 Sep 29.

Abstract

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.

Keywords: Beta blocker; Ovarian cancer; Survival.

MeSH terms

  • Adenocarcinoma, Clear Cell / epidemiology
  • Adenocarcinoma, Clear Cell / pathology
  • Adenocarcinoma, Clear Cell / surgery*
  • Adrenergic beta-Antagonists / therapeutic use*
  • Aged
  • Carcinoma, Endometrioid / epidemiology
  • Carcinoma, Endometrioid / pathology
  • Carcinoma, Endometrioid / surgery*
  • Carcinoma, Ovarian Epithelial
  • Case-Control Studies
  • Comorbidity
  • Cytoreduction Surgical Procedures / methods*
  • Disease-Free Survival
  • Female
  • Humans
  • Hypertension / epidemiology
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Grading
  • Neoplasms, Cystic, Mucinous, and Serous / epidemiology
  • Neoplasms, Cystic, Mucinous, and Serous / pathology
  • Neoplasms, Cystic, Mucinous, and Serous / surgery*
  • Neoplasms, Glandular and Epithelial / epidemiology
  • Neoplasms, Glandular and Epithelial / pathology
  • Neoplasms, Glandular and Epithelial / surgery*
  • Ovarian Neoplasms / epidemiology
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / surgery*
  • Perioperative Care / methods*
  • Proportional Hazards Models
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome

Substances

  • Adrenergic beta-Antagonists