The impact of perioperative β blocker use on patient outcomes after primary cytoreductive surgery in high-grade epithelial ovarian carcinoma
Al-niaimi A, Dickson EL, Albertin C, et al. The impact of perioperative β blocker use on patient outcomes after primary cytoreductive surgery in high-grade epithelial ovarian carcinoma. Gynecol Oncol. 2016;143(3):521-525. DOI: 10.1016/j.ygyno.2016.09.019
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.