Abstract 10879: Risk of Cardiac-Specific Mortality Among Ovarian Cancer Survivors: A Population-Based Study

Abstract

Background: Ovarian cancer ranks as the fifth deadliest cancer among women and the top cause of female reproductive cancers. Studies identifying the consequences of treatment modalities are not well defined in the literature. We aim to compare the cardio-oncologic effect of therapy amongst ovarian cancer survivors. Methods: Data on patients diagnosed with ovarian cancer between 2000 and 2016 was extracted from the Surveillance, Epidemiology and End Results (SEER) registry. Patients were included when greater than 18 years of age at diagnosis and survival was 60 months or greater. Results: A total of 27,003 cancer patients were identified from the SEER registry. At diagnosis, the mean age was 55.6 ± 14.1 years; approximately 29.6% presented with localized cancer, 29.2% with regional cancer, and 37.3% with distant cancer. Overall, the median cardiac-specific survival time was 100 months compared to 80 months due to the primary cancer (log rank P < 0.001). Survival estimates are plotted in Figure 1. Ten-, and fifteen-year cardiac-specific survival for ovarian cancer was 82%, and 24%, respectively. Adjusted Cox proportional hazard models revealed an increased cardiac-specific mortality when using chemotherapy alone [HR 2.210, 95% CI 1.851 to 2.640, P < 0.001] and with any chemotherapy use [HR 1.937, 95% CI 1.841 to 2.037, P < 0.001]. Decreased cardiac-specific mortality was noted with surgery alone [HR 0.526, 95% CI 0.459 to 0.603, P < 0.001] and with combination surgery and radiation [HR 0.612, 95% CI 0.408 to 0.918, P = 0.18]. Conclusion: Survivors of ovarian cancer are burdened by cardiac sequelae. The median survival time was twenty months greater for cardiac-specific mortality than the primary cancer. Death risk from diseases of the heart was significantly increased for patients receiving chemotherapy. Figure 1. Kaplan-Meier Survival EstimatesEstimated survival times by diseases of heart, primary cancer, and all other causes of death.