Table 5.
Risk factors for urinary and genital organ disorders among ovarian cancer survivors
| Urinary system disorders | Genital organ disorders | |||
|---|---|---|---|---|
| 1 to <5 years | 5+ years | 1 to <5 years | 5+ years | |
| HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | |
| Cancer Treatmenta | ||||
| Surgery only | Reference | Reference | Reference | Reference |
| Surgery and chemotherapy | 1.81 (1.33, 2.46) | 0.89 (0.57, 1.38) | 1.27 (0.85, 1.88) | 1.39 (0.58, 3.35) |
| other treatmente | 2.76 (1.58, 4.82) | 1.01 (0.23, 4.43) | 1.26 (0.62, 2.60) | 2.62 (0.31, 22.23) |
| Surgery Typea | ||||
| Limited surgeryg | Reference | Reference | Reference | Reference |
| Aggressive surgeryg | 3.34 (2.14, 5.22) | 1.32 (0.80, 2.16) | 1.53 (0.88, 2.65) | 2.74 (0.80, 9.47) |
| Cancer Stagea | ||||
| Localized | Reference | Reference | Reference | Reference |
| Regional | 1.39 (0.88, 2.22) | 1.05 (0.59, 1.88) | 1.01 (0.55, 1.84)* | 0.71 (0.15, 3.49) |
| Advanced | 3.11 (2.18, 4.45) | 1.21 (0.73, 2.00) | 1.27 (0.82, 1.97)* | 2.10 (0.86, 5.12) |
| Histologya | ||||
| High-grade serous | Reference | Reference | Reference | Reference |
| Low-grade serous | 0.67 (0.21, 2.13) | 8.9 (2.99, 26.5) | --- | 0.76 (0.09, 6.79) |
| Endometrioid | 0.38 (0.23, 0.64) | 0.91 (0.47, 1.77) | 0.83 (0.44, 1.56) | 1.57 (0.52, 4.76) |
| Mucinous | 0.51 (0.29, 0.88) | 1.07 (0.55, 2.09) | 1.01 (0.55, 1.87) | 1.35 (0.36, 5.04) |
| Clear Cell | 0.57 (0.32, 1.02) | 1.58 (0.71, 3.52) | 1.16 (0.59, 2.26) | --- |
| Carcinosarcoma | 2.00 (0.79, 5.08) | --- | 0.51 (0.07, 3.74) | --- |
| Carcinoma, NOS | 0.75 (0.44, 1.25) | 0.74 (0.28, 1.91) | 0.83 (0.38, 1.81) | 2.52 (0.50, 12.60) |
| Other typef | 0.54 (0.32, 0.91) | 0.34 (0.13, 0.92) | 0.70 (0.36, 1.37) | 1.96 (0.55, 6.94) |
| Baseline BMIb | ||||
| <18 kg/m2 | 1.31 (0.61, 2.83) | 1.11 (0.27, 4.61) | 1.48 (0.53, 4.14) | --- |
| 18 to 24 kg/m2 | Reference | Reference | Reference | Reference |
| 25 to 29 kg/m2 | 1.11 (0.81, 1.53) | 0.79 (0.45, 1.37) | 1.54 (1.05, 2.24) | 1.08 (0.41, 2.89) |
| 30+ kg/m2 | 1.15 (0.82, 1.63) | 1.50 (0.87, 2.60) | 1.03 (0.65, 1.64) | 2.01 (0.74, 5.45) |
| Age at Cancer Diagnosisc | ||||
| 18–49 | Reference | Reference | Reference | Reference |
| 50–59 | 1.48 (1.03, 2.12) | 1.55 (0.87, 2.75) | 0.82 (0.53, 1.27) | 0.46 (0.15, 1.35) |
| 60–69 | 1.43 (0.97, 2.11) | 2.89 (1.59, 5.24) | 0.59 (0.36, 0.96) | 0.71 (0.24, 2.10) |
| 70–79 | 1.31 (0.87, 1.98) | 5.45 (2.86, 10.38) | 0.48 (0.28, 0.84) | 0.81 (0.25, 2.66) |
| 80+ | 2.85 (1.62, 5.01) | 4.89 (0.65, 36.98) | 0.76 (0.35, 1.66) | --- |
| Baseline CCId | ||||
| 0 | Reference | Reference | Reference | Reference |
| 1 | 1.31 (0.93, 1.83) | 1.22 (0.64, 2.31) | 0.82 (0.52, 1.29) | 0.50 (0.11, 2.21) |
| 2+ | 2.71 (1.84, 3.99) | 0.72 (0.21, 2.45) | 1.44 (0.89, 2.34) | 0.34 (0.04, 2.76) |
Abbreviation: HR, hazard ratio; CI, confident interval; CCI, Charlson Comorbidity Index.
Model adjusted for
age at diagnosis, baseline BMI, baseline CCI, race;
age at diagnosis, baseline CCI, race;
baseline BMI, baseline CCI;
age at diagnosis, baseline BMI, race.
Chemotherapy only, surgery and radiation only, chemotherapy and radiation only, surgery and radiation and chemotherapy only.
Malignant Brenner, mixed, sarcoma, non-specific.
Limited surgery: removal of tumor or unilateral/bilateral oophorectomy (with or without hysterectomy).
Aggressive surgery: surgery with omentectomy, debulking, pelvic exenteration.
Proportional hazards assumption not met; flexible model used.