Urinary heavy metals and overall survival of advanced high-grade serous ovarian cancer: A nested case-control study in China

• Published in: Ecotoxicology and environmental safety Vol. 286; p. 117176
• Main Authors: Liu, Jia-Xin, Liu, Fang-Hua, Qin, Xue, Bao, Qi, Zheng, Wen-Rui, Xing, Wei-Yi, Wu, Lang, Li, Yi-Zi, Xu, He-Li, Wei, Yi-Fan, Li, Xiao-Ying, Huang, Dong-Hui, Gao, Song, Wang, Lei, Ma, Qi-Peng, Gong, Ting-Ting, Wu, Qi-Jun
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.11.2024; Elsevier
• Subjects: Heavy metals; Nested case-control study; Ovarian cancer; Survival; Urine; Urine; Nested case-control study; Survival; Heavy metals; Ovarian cancer
• ISSN: 0147-6513; 1090-2414; 1090-2414
• DOI: 10.1016/j.ecoenv.2024.117176

Environmental pollution has emerged as a significant determinant in ovarian cancer prognosis. However, limited evidence exists regarding the correlations between heavy metals and ovarian cancer prognosis. To elucidate the relationship between urinary heavy metals and their mixtures with overall survival (OS) of advanced high-grade serous ovarian cancer (HGSOC). Within the Ovarian Cancer Follow-Up Study, we conducted a nested case-control study. A sum of 159 deceased patients and an equal number of alive patients were included, matched by sample date, body mass index, and age at diagnosis. Urinary concentrations of five heavy metals were quantified: arsenic (As), cadmium (Cd), chromium (Cr), mercury (Hg), and lead (Pb). Conditional logistic regression models were employed to calculate odds ratios (ORs) and their 95 % confidence intervals (CIs). To elucidate joint effects, we utilized quantile g-computation and Bayesian kernel machine regression models. For the multivariable adjusted conditional logistic regression model, significant associations were found between high urinary levels of As (OR=1.99, 95 %CI: 1.05–3.79), Cd (OR=2.56, 95 %CI: 1.29–5.05), Hg (OR=2.24, 95 %CI: 1.09–4.62), and Pb (OR=3.80, 95 %CI: 1.75–8.27) and worse OS of HGSOC, comparing the highest tertile to the lowest. Analysis of joint effects showed that elevated concentrations of heavy metal mixtures were related to poor OS of HGSOC. Pb exhibited the highest contribution to the overall association within the metal mixtures. High urinary heavy metal concentrations were linked to worse OS of HGSOC. Future research is necessary to validate our findings. •First to explore urinary heavy metals with overall survival of ovarian cancer.•Urinary As, Cd, Hg, and Pb were related to poor overall survival of ovarian cancer.•Heavy metal mixture had an adverse effect on overall survival of ovarian cancer.