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Impact of cardiovascular comorbidity on ovarian cancer mortality
Journal article   Open access   Peer reviewed

Impact of cardiovascular comorbidity on ovarian cancer mortality

Eileen H Shinn, Daniel J Lenihan, Diana L Urbauer, Karen M Basen-Engquist, Alan Valentine, Laura Palmero, Myrshia L Woods, Pooja Patel, Alpa M Nick, Mian M. K Shahzad, …
Cancer epidemiology, biomarkers & prevention, Vol.22(11), pp.2102-2109
11/2013
DOI: 10.1158/1055-9965.EPI-13-0625
PMCID: PMC3830519
PMID: 24045927
url
https://doi.org/10.1158/1055-9965.EPI-13-0625View
Published (Version of record) Open Access

Abstract

Background: A retrospective cohort study utilizing prospectively collected data was conducted from August 2003 until March 2008 at M.D. Anderson Cancer Center. It is unknown whether cardiovascular comorbidity and chronic stress impact ovarian cancer outcome, which remains poor despite advances in therapy. The purpose of this study was to determine whether cardiovascular disease and markers that may be associated with stress are also associated with survival in patients with ovarian cancer. Methods: Participants with newly diagnosed epithelial ovarian cancer were followed until time of death or truncation of study period (median follow-up = 4.2 years; n = 271). Tumor characteristics (stage, tumor grade, histology, debulking status), demographic variables, and cardiovascular comorbidity were documented and compared to overall survival. Results: Of the nine cardiovascular events tracked during follow-up, venous thromboembolism [VTE; HR, 3.2; 95% confidence interval (CI), 1.8–5.5] and pulmonary hypertension (HR, 8.5; 95% CI, 3.9–18.7) were associated with shorter survival in multivariate analysis. In addition, high tumor grade, suboptimal cytoreduction, and baseline heart rate (HR, 1.02; 95% CI, 1.01–1.04) were related to decreased survival. Conclusion: Careful management of certain cardiovascular comorbidities may extend survival in patients with ovarian cancer. Our findings suggest that increased baseline heart rate and the development of VTE and pulmonary hypertension after cancer diagnosis may be significant predictors of survival in women with ovarian cancer. Impact: Our study emphasizes the importance of identifying and optimally treating tachycardia, VTE, and pulmonary hypertension in conjunction with cancer therapy.
Ovarian Cancer tachycardia VTE survival

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