The prognostic value of calcium channel blockers usage for overall survival and recurrence-free survival in patients with endometrial cancer.

OBJECTIVE

To evaluate the prognosis for endometrial cancer (EC) patients who used calcium channel blockers (CCB) with hypertension and its predictive function.

METHODS

Patients diagnosed with EC who underwent surgery at our hospital between January 2014 and December 2023 were enrolled and divided into a training set and a validation set at a 2:1 ratio. Clinical characteristics and medical information were extracted from patient records. Predictive factors were assessed using univariate and multivariate analyses in the training set. ROC and DCA were employed to evaluate the predictive value of CCB in both the training and validation sets. Survival analysis was conducted to investigate function of antihypertensive drugs and calcium level.

RESULTS

In the training set, univariate analysis showed that age, CA125, CCB use, tumor grade, FIGO stage, histological type, peritoneal cytology, lymph node metastasis, and lymph-vascular space invasion (LVSI) were significantly associated with overall survival (OS) and recurrence-free survival (RFS; all P < 0.05). After adjusting for confounders, CCB use remained independently predictive of improved OS (Model I: HR = 0.1, 95% CI: 0.0-0.4, P < 0.001; Model II: HR = 0.2, 95% CI: 0.1-0.5, P = 0.006) and RFS (Model I: HR = 0.2, 95% CI: 0.1-0.5, P < 0.001; Model II: HR = 0.2, 95% CI: 0.1-0.7, P = 0.009). Both CCB and calcium ion levels have significant impacts on the long-term survival of patients with hypertension. ROC and DCA demonstrated that incorporating CCB use significantly enhanced diagnostic accuracy for OS and RFS in both the training and validation sets. Survival analyses further supported these findings.

CONCLUSION

This study suggests that hypertensive EC patients using CCB exhibit significantly improved OS and RFS prediction accuracy, with consistent results across training and validation cohorts.