title: Impact of cardiovascular comorbidity on ovarian cancer mortality.
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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  Our study emphasizes the importance of identifying and optimally treating tachycardia, VTE, and pulmonary hypertension in conjunction with cancer therapy.
authors.affiliation: Authors' Affiliations: University of Texas M.D. Anderson Cancer Center, Houston, Texas; Vanderbilt University Medical Center, Nashville, Tennessee; IDDI Corp., Houston, Texas; University of Texas Medical Branch at Galveston, Galveston, Texas; Moffitt Cancer Center, Tampa, Florida; University of Arkansas for Medical Sciences, Little Rock, Arkansas; St. Luke's Roosevelt Hospital Center, New York, New York; and University of Iowa, Iowa City, Iowa.
authors.forename: Eileen H
authors.initials: EH
authors.lastname: Shinn
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Lenihan
authors.forename: Diana L
authors.initials: DL
authors.lastname: Urbauer
authors.forename: Karen M
authors.initials: KM
authors.lastname: Basen-Engquist
authors.forename: Alan
authors.initials: A
authors.lastname: Valentine
authors.forename: Laura
authors.initials: L
authors.lastname: Palmero
authors.forename: Myrshia L
authors.initials: ML
authors.lastname: Woods
authors.forename: Pooja
authors.initials: P
authors.lastname: Patel
authors.forename: Alpa M
authors.initials: AM
authors.lastname: Nick
authors.forename: Mian M K
authors.initials: MM
authors.lastname: Shahzad
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Stone
authors.forename: Antoinette
authors.initials: A
authors.lastname: Golden
authors.forename: Emma
authors.initials: E
authors.lastname: Atkinson
authors.forename: Susan K
authors.initials: SK
authors.lastname: Lutgendorf
authors.forename: Anil K
authors.initials: AK
authors.lastname: Sood
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000077216:Carcinoma, Ovarian Epithelial; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000473:pathology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000401:mortality* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000473:pathology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D055815:Young Adult
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