Association between Resting Heart Rate and Oncological Outcomes in Patients with Early-Stage Cervical Cancer Who Have Undergone Radical Hysterectomy with Pelvic Lymphadenectomy

Abstract

Introduction: A few studies have explored the association of resting heart rate (RHR) with mortality and/or other oncological outcomes in patients with specific cancers such as breast, colorectal, and lung cancer. This study aimed to evaluate the association between the RHR and oncological outcomes in patients with early-stage cervical cancer (CC) who underwent radical surgical resection. Methods: We included 622 patients with early-stage CC (stage IA2–IB1). The patients were divided into four groups based on the RHR as follows: quartile 1, ≤ 64; quartile 2, 65–70; quartile 3, 71–76; and quartile 4, >76 beats per min [bpm], with the lowest quartile being the reference group. We evaluated the associations of the RHR and clinicopathological features with oncological outcomes using Cox proportional-hazards regression. Results: There were clear among-group differences. Further, there was a significant positive correlation of RHR with tumor size and deep stromal invasion. Multivariate analysis revealed that RHR was an independent prognostic factor for disease-free survival (DFS) and overall survival (OS). Compared with patients with an RHR ≤ 70 bpm, those with an RHR of 71–76 bpm had a 1.84- and 3.05-times higher likelihood of DFS (p = 0.016) and OS (p = 0.030), respectively, while those with RHR > 76 bpm had a 2.20-times higher likelihood of DFS (p = 0.016). Conclusion: This is the first study to demonstrate that RHR may be an independent prognostic factor for oncological outcomes in patients with CC.