@article{b23195a4a1524c20b313cb0fdad1ef19,
title = "Cigarette smoking is associated with adverse survival among women with ovarian cancer: Results from a pooled analysis of 19 studies",
abstract = "Cigarette smoking is associated with an increased risk of developing mucinous ovarian tumors but whether it is associated with ovarian cancer survival overall or for the different histotypes is unestablished. Furthermore, it is unknown whether the association between cigarette smoking and survival differs according to strata of ovarian cancer stage at diagnosis. In a large pooled analysis, we evaluated the association between various measures of cigarette smoking and survival among women with epithelial ovarian cancer. We obtained data from 19 case-control studies in the Ovarian Cancer Association Consortium (OCAC), including 9,114 women diagnosed with ovarian cancer. Cox regression models were used to estimate adjusted study-specific hazard ratios (HRs), which were combined into pooled hazard ratios (pHR) with corresponding 95% confidence intervals (CIs) under random effects models. Overall, 5,149 (57%) women died during a median follow-up period of 7.0 years. Among women diagnosed with ovarian cancer, both current (pHR = 1.17, 95% CI: 1.08–1.28) and former smokers (pHR = 1.10, 95% CI: 1.02–1.18) had worse survival compared with never smoking women. In histotype-stratified analyses, associations were observed for mucinous (current smoking: pHR = 1.91, 95% CI: 1.01–3.65) and serous histotypes (current smoking: pHR = 1.11, 95% CI: 1.00–1.23; former smoking: pHR = 1.12, 95% CI: 1.04–1.20). Further, our results suggested that current smoking has a greater impact on survival among women with localized than disseminated disease. The identification of cigarette smoking as a modifiable factor associated with survival has potential clinical importance as a focus area to improve ovarian cancer prognosis.",
keywords = "cigarette smoking, ovarian cancer, pooled analysis, survival",
author = "{on behalf of the Ovarian Cancer Association Consortium} and {On behalf of the Australian Ovarian Cancer Study Group} and Camilla Pr{\ae}stegaard and Allan Jensen and Jensen, {Signe M.} and Nielsen, {Thor S.S.} and Webb, {Penelope M.} and Nagle, {Christina M.} and Anna DeFazio and Estrid H{\o}gdall and Rossing, {Mary Anne} and Doherty, {Jennifer A.} and Wicklund, {Kristine G.} and Goodman, {Marc T.} and Francesmary Modugno and Kirsten Moysich and Ness, {Roberta B.} and Robert Edwards and Keitaro Matsuo and Satoyo Hosono and Goode, {Ellen L.} and Winham, {Stacey J.} and Fridley, {Brooke L.} and Cramer, {Daniel W.} and Terry, {Kathryn L.} and Schildkraut, {Joellen M.} and Andrew Berchuck and Bandera, {Elisa V.} and Paddock, {Lisa E.} and Massuger, {Leon F.} and Nicolas Wentzensen and Paul Pharoah and Honglin Song and Alice Whittemore and Valerie McGuire and Weiva Sieh and Joseph Rothstein and Hoda Anton-Culver and Argyrios Ziogas and Usha Menon and Gayther, {Simon A.} and Ramus, {Susan J.} and Alexandra Gentry-Maharaj and Wu, {Anna H.} and Pearce, {Celeste L.} and Malcolm Pike and Lee, {Alice W.} and Rebecca Sutphen and Jenny Chang-Claude and Risch, {Harvey A.} and Kjaer, {Susanne K.}",
note = "Funding Information: We are grateful to the family and friends of Kathryn Sladek Smith for their generous support of the Ovarian Cancer Association Consortium through their donations to the Ovarian Cancer Research Fund. The MALOVA study is grateful to Kirsten Frederiksen for statistical support and to Nick Martinussen for data management assistance. The NJO group thanks the New Jersey State Cancer Registry staff, M. King and L. Rodriguez. The SEARCH group thanks the SEARCH team, Craig Luccarini, Caroline Baynes and Don Conroy. The UKOPS group thanks I. Jacobs, M. Widschwendter, E. Wozniak, A. Ryan, J. Ford and N. Balogun for their contribution to the study (UKO). The German group thanks Ursula Eilber and Tanja Koehler for competent technical assistance (GER). The Australian group thanks all the clinical and scientific collaborators (http://www.aocstudy.org/) and the women for their contribution (AUS). The cooperation of the 32 Connecticut hospitals, including Stamford Hospital, in allowing patient access, is gratefully acknowledged (CON). Certain data in the CON study were obtained from the Connecticut Tumor Registry, Connecticut Department of Public Health. The CON study assumes full responsibility for analyses and interpretation of these data. Publisher Copyright: {\textcopyright} 2017 UICC",
year = "2017",
month = jun,
day = "1",
doi = "10.1002/ijc.30600",
language = "English (US)",
volume = "140",
pages = "2422--2435",
journal = "International Journal of Cancer",
issn = "0020-7136",
publisher = "Wiley-Liss Inc.",
number = "11",
}