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, Rebecca L. Stone, Antoinette Golden, Emma Atkinson, Susan K. Lutgendorf, Anil K. Sood

Research output: Contribution to journalArticle

10 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)2102-2109
Number of pages8
JournalCancer Epidemiology Biomarkers and Prevention
Volume22
Issue number11
DOIs
StatePublished - Nov 2013

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ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Shinn, E. H., Lenihan, D. J., Urbauer, D. L., Basen-Engquist, K. M., Valentine, A., Palmero, L., Woods, M. L., Patel, P., Nick, A. M., Shahzad, M. M. K., Stone, R. L., Golden, A., Atkinson, E., Lutgendorf, S. K., & Sood, A. K. (2013). Impact of cardiovascular comorbidity on ovarian cancer mortality. Cancer Epidemiology Biomarkers and Prevention, 22(11), 2102-2109. https://doi.org/10.1158/1055-9965.EPI-13-0625