The obesity and lipid metabolism were previously proposed to be related with the clinical outcomes of metastatic renal cell carcinoma (mRCC). We tried to investigate the relationship between preoperative cholesterol level (PCL) and survival outcomes in patients with mRCC.
We analysed the data of 244 patients initially treated with cyto-reductive nephrectomy after being diagnosed with mRCC. Patients were stratified into two groups according to the PCL cut-off level of 170 mg/dL. The postoperative survival rates were compared using Kaplan-Meier analysis and the possible predictors of patients' cancer-specific survival (CSS) and overall survival (OS) were tested using multivariate Cox-proportional hazard models.
The low cholesterol group showed significantly worse postoperative CSS (p = 0.013) and OS (p = 0.009) than the high cholesterol group. On multivariate analysis, low PCL was revealed as an independent predictor of worse CSS (hazard ratio [HR], 2.162; 95% CI, 1.221-3.829; p = 0.008) and OS (HR, 2.013; 95% CI, 1.206-3.361; p = 0.007). Subsequent subgroup analysis showed that these results were maintained in the clear cell subgroup but not in the non-clear cell subgroup.
Decreased PCL was significantly correlated with worse survival outcomes in patients with mRCC treated with cytoreductive nephrectomy. The underlined mechanism is still uncharted and requires further investigation.
BMC cancer. 2017 May 25*** epublish ***
Hakmin Lee, Yong June Kim, Eu Chang Hwang, Seok Ho Kang, Sung-Hoo Hong, Jinsoo Chung, Tae Gyun Kwon, Cheol Kwak, Hyeon Hoe Kim, Jong Jin Oh, Sang Chul Lee, Sung Kyu Hong, Sang Eun Lee, Seok-Soo Byun, KOrean Renal Cell Carcinoma (KORCC) Group
Department of Urology, Seoul National University Bundang Hospital, Seongnam, South Korea., Department of Urology, Chungbuk National University College of Medicine, Cheongju, South Korea., Department of Urology, Chonnam National University Hwasun Hospital, Hwasun, South Korea., Department of Urology, Korea University School of Medicine, Seoul, South Korea., Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, South Korea., Department of Urology, National Cancer Center, Goyang, South Korea., Department of Urology, Kyungpook National University College of Medicine, Daegu, South Korea., Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea., Department of Urology, Seoul National University Bundang Hospital, Seongnam, South Korea. .