Preoperative serum lipid profile and outcome in nonmetastatic colorectal cancer

Objective: A large portion of non-metastatic colorectal cancers (non-mCRCs) recur after curative surgery. In addition to the traditional tumor-related factors, host-related factors are also required to accurately predict prognosis. A few studies have shown an association between the serum lipid prof...

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Autores principales:	Ting-Ting Hong, Di Shen, Xiao-Ping Chen, Xiao-Hong Wu, Dong Hua
Formato:	article
Lenguaje:	EN
Publicado:	KeAi Communications Co., Ltd. 2016
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/815b288940f24d9aa8d541aeba28ac90
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spelling	oai:doaj.org-article:815b288940f24d9aa8d541aeba28ac902021-12-02T13:37:26ZPreoperative serum lipid profile and outcome in nonmetastatic colorectal cancer2095-882X10.1016/j.cdtm.2016.11.015https://doaj.org/article/815b288940f24d9aa8d541aeba28ac902016-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095882X16300615https://doaj.org/toc/2095-882XObjective: A large portion of non-metastatic colorectal cancers (non-mCRCs) recur after curative surgery. In addition to the traditional tumor-related factors, host-related factors are also required to accurately predict prognosis. A few studies have shown an association between the serum lipid profile and the survival and treatment response of patients with colorectal cancer. Methods: We retrospectively evaluated the prognostic significance of the preoperative serum lipid profile [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)] in patients with non-mCRC treated with curative surgery. The Spearman rank correlation test was used to analyze associations between lipid levels and categorical variables. Lipid levels were modeled as four equal-sized quartiles based on the distribution among the whole cohort. Kaplan-Meier curves were used to estimate survival probabilities, and the log-rank test was used to detect differences between them. Multivariate fractional polynomial (MFP) analysis was used to model any non-linear effects and avoid categorization. To evaluate the added prognostic value of lipids, the predictive power of two models (with and without lipids as covariates) was compared by using Harrell's C-statistic and the Akaike information criterion (AIC). Results: A total of 266 patients with non-mCRC were enrolled in the present study. Spearman rank correlation test showed that TGÂ levels inversely correlated with N stage (r = â0.20, PÂ =Â 0.00) and Tumor-Node-Metastasis (TNM) stage (r = â0.19, P = 0.00). HDL-C levels positively correlated with perineural invasion (PNI) (r = 0.15, PÂ = 0.02), and LDL-C levels inversely correlated with lymphovascular invasion (LVI) (r = â0.12, PÂ =Â 0.04). None of the four lipids predicted overall survival (OS) in univariate or multivariate analyses adjusted for age, gender, T stage, N stage, TNM stage, histological grade, tumor deposits, LVI, PNI, and adjuvant treatment (all P > 0.05). In agreement, the Kaplan-Meier curves for OS according to the lipid quartiles were not significantly different, as confirmed by the log-rank test (all P > 0.05). MFPÂ analysis also found no significant associations between lipid levels and OS (all P > 0.05). A prognostic model that included lipids had a higher Harrell's C-statistic and a lower AIC value than did a model that did not include lipids (for Harrell's C-statistic: 0.82 vs. 0.77; for AIC: 398 vs. 432). Conclusion: Measuring preoperative serum lipid levels may be a simple and cost-effective way of increasing prognostic accuracy in patients with non-mCRC treated with curative surgery. Keywords: Serum lipids, Colorectal cancer, Overall survival, Prognostic modelTing-Ting HongDi ShenXiao-Ping ChenXiao-Hong WuDong HuaKeAi Communications Co., Ltd.articleMedicine (General)R5-920ENChronic Diseases and Translational Medicine, Vol 2, Iss 4, Pp 241-249 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 Ting-Ting Hong Di Shen Xiao-Ping Chen Xiao-Hong Wu Dong Hua Preoperative serum lipid profile and outcome in nonmetastatic colorectal cancer
description	Objective: A large portion of non-metastatic colorectal cancers (non-mCRCs) recur after curative surgery. In addition to the traditional tumor-related factors, host-related factors are also required to accurately predict prognosis. A few studies have shown an association between the serum lipid profile and the survival and treatment response of patients with colorectal cancer. Methods: We retrospectively evaluated the prognostic significance of the preoperative serum lipid profile [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)] in patients with non-mCRC treated with curative surgery. The Spearman rank correlation test was used to analyze associations between lipid levels and categorical variables. Lipid levels were modeled as four equal-sized quartiles based on the distribution among the whole cohort. Kaplan-Meier curves were used to estimate survival probabilities, and the log-rank test was used to detect differences between them. Multivariate fractional polynomial (MFP) analysis was used to model any non-linear effects and avoid categorization. To evaluate the added prognostic value of lipids, the predictive power of two models (with and without lipids as covariates) was compared by using Harrell's C-statistic and the Akaike information criterion (AIC). Results: A total of 266 patients with non-mCRC were enrolled in the present study. Spearman rank correlation test showed that TGÂ levels inversely correlated with N stage (r = â0.20, PÂ =Â 0.00) and Tumor-Node-Metastasis (TNM) stage (r = â0.19, P = 0.00). HDL-C levels positively correlated with perineural invasion (PNI) (r = 0.15, PÂ = 0.02), and LDL-C levels inversely correlated with lymphovascular invasion (LVI) (r = â0.12, PÂ =Â 0.04). None of the four lipids predicted overall survival (OS) in univariate or multivariate analyses adjusted for age, gender, T stage, N stage, TNM stage, histological grade, tumor deposits, LVI, PNI, and adjuvant treatment (all P > 0.05). In agreement, the Kaplan-Meier curves for OS according to the lipid quartiles were not significantly different, as confirmed by the log-rank test (all P > 0.05). MFPÂ analysis also found no significant associations between lipid levels and OS (all P > 0.05). A prognostic model that included lipids had a higher Harrell's C-statistic and a lower AIC value than did a model that did not include lipids (for Harrell's C-statistic: 0.82 vs. 0.77; for AIC: 398 vs. 432). Conclusion: Measuring preoperative serum lipid levels may be a simple and cost-effective way of increasing prognostic accuracy in patients with non-mCRC treated with curative surgery. Keywords: Serum lipids, Colorectal cancer, Overall survival, Prognostic model
format	article
author	Ting-Ting Hong Di Shen Xiao-Ping Chen Xiao-Hong Wu Dong Hua
author_facet	Ting-Ting Hong Di Shen Xiao-Ping Chen Xiao-Hong Wu Dong Hua
author_sort	Ting-Ting Hong
title	Preoperative serum lipid profile and outcome in nonmetastatic colorectal cancer
title_short	Preoperative serum lipid profile and outcome in nonmetastatic colorectal cancer
title_full	Preoperative serum lipid profile and outcome in nonmetastatic colorectal cancer
title_fullStr	Preoperative serum lipid profile and outcome in nonmetastatic colorectal cancer
title_full_unstemmed	Preoperative serum lipid profile and outcome in nonmetastatic colorectal cancer
title_sort	preoperative serum lipid profile and outcome in nonmetastatic colorectal cancer
publisher	KeAi Communications Co., Ltd.
publishDate	2016
url	https://doaj.org/article/815b288940f24d9aa8d541aeba28ac90
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Preoperative serum lipid profile and outcome in nonmetastatic colorectal cancer

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