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


CONCLUSIONS
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.
Division of Gynecologic Oncology, Department of OBGYN, University of Wisconsin, Madison, WI, USA. Electronic address: alniaimi@wisc.edu.
Ahmed
A
Al-Niaimi
Department of Gynecologic Oncology, Aurora Medical Group, Milwaukee, WI, USA.
Elizabeth L
EL
Dickson
Division of Gynecologic Oncology, Department of OBGYN, University of Minnesota, Minneapolis, MN, USA.
Cassandra
C
Albertin
Division of Gynecologic Oncology, Department of OBGYN, University of Wisconsin, Madison, WI, USA.
Jennifer
J
Karnowski
Division of Gynecologic Oncology, Department of OBGYN, University of Wisconsin, Madison, WI, USA.
Cassandra
C
Niemi
Division of Gynecologic Oncology, Department of OBGYN, University of Wisconsin, Madison, WI, USA.
Ryan
R
Spencer
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.
Mian M K
MM
Shahzad
Division of Gynecologic Oncology, Department of OBGYN, University of Wisconsin, Madison, WI, USA.
Shitanshu
S
Uppal
Division of Gynecologic Oncology, Department of OBGYN, University of Wisconsin, Madison, WI, USA.
Sandeep
S
Saha
Division of Gynecologic Oncology, Department of OBGYN, University of Wisconsin, Madison, WI, USA.
Laurel
L
Rice
Department of Gynecologic Oncology, Minnesota Oncology, Minneapolis, MN, USA.
Amy Mc
AM
Nally
D018262:Adenocarcinoma, Clear Cell / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D018269:Carcinoma, Endometrioid / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D000077216:Carcinoma, Ovarian Epithelial; D016022:Case-Control Studies; D015897:Comorbidity; D065426:Cytoreduction Surgical Procedures / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D009375:Neoplasms, Glandular and Epithelial / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D019990:Perioperative Care / Q000379:methods*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists
Beta blocker; Ovarian cancer; Survival