Abstract
Objective
Vagal nerve activity, indexed by heart rate variability (HRV), may play a protective role in many cancers. For example, high HRV was found to predict better overall survival in patients with liver, lung, pancreatic and breast cancers. This study aimed to evaluate the prognostic role of HRV in ovarian cancer.
Methods
This was a retrospective comparative cross-sectional study. All patients with histologically proven ovarian cancer treated at one tertiary center between 2014 and 2021 were included. HRV was derived and analyzed from patients’ electrocardiograms at the time of diagnosis. The primary outcome was overall survival.
Results
The final cohort included 104 women aged 64.7±12.3 years. Most of the patients (83.8%) had advanced disease stages (stages III and IV). Using multivariate logistic regression, controlling for age, cancer stage, surgical outcomes, and treatment type, log-HRV significantly predicted survival in patients younger than 60 years (OR = 0.01; 95% CI: 0.00–0.93, p < 0.05). Finally, examination of the effects of HRV on the influence of known prognostic factors revealed that tumor stage tended to predict survival only for patients with low HRV, whereas surgical outcomes and treatment type significantly predicted survival only in patients with high HRV.
Conclusions
Our study confirmed that vagal nerve activity, indexed by HRV, might predict survival in patients with ovarian cancer, especially in women younger than 60 years. In addition, HRV may determine the effects of known prognostic factors on survival. The results of our study suggest that the HRV should be considered when estimating patient prognosis and treatment success in patients with ovarian cancer.