Ho Won Kang1,2, Sung Pil Seo1,2, Won Tae Kim1,2, Seok Joong Yun1,2, Sang-Cheol Lee1,2, Wun-Jae Kim1,2, Eu Chang Hwang3, Seok Ho Kang4, Sung-Hoo Hong5, Jinsoo Chung6, Tae Gyun Kwon7, Hyeon Hoe Kim8, Cheol Kwak8, Seok-Soo Byun9, Yong-June Kim10,11. 1. Department of Urology, Chungbuk National University College of Medicine, 1st Chungdae-ro, Seowon-gu, Cheongju, Chungbuk, 28644, South Korea. 2. Department of Urology, Chungbuk National University Hospital, Cheongju, South Korea. 3. Department of Urology, Chonnam National University Hwasun Hospital, Gwangju, Jeonnam, South Korea. 4. Department of Urology, Korea University School of Medicine, Seoul, South Korea. 5. Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, South Korea. 6. Department of Urology, National Cancer Center, Goyang, South Korea. 7. Department of Urology, Kyungpook National University College of Medicine, Daegu, South Korea. 8. Department of Urology, Seoul National University College of Medicine, Seoul, South Korea. 9. Department of Urology, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam, Kyunggi-do, 463-707, South Korea. ssbyun@snubh.org. 10. Department of Urology, Chungbuk National University College of Medicine, 1st Chungdae-ro, Seowon-gu, Cheongju, Chungbuk, 28644, South Korea. urokyj@cbnu.ac.kr. 11. Department of Urology, Chungbuk National University Hospital, Cheongju, South Korea. urokyj@cbnu.ac.kr.
Abstract
BACKGROUND: The prognostic implications of preoperative serum total cholesterol (TC) level in patients with renal cell carcinoma (RCC) remain poorly understood. We investigated the prognostic role of preoperative serum TC in patients with surgically treated RCC from a large, multi-institutional Korean collaboration. PATIENTS AND METHODS: A database of 3064 patients with RCC who underwent radical or partial nephrectomy between 1999 and 2011 at eight academic centers was analyzed. Preoperative serum TC levels were measured in fasting blood samples. RESULTS: Low preoperative serum TC level was associated with aggressive tumor characteristics, including large tumor size, advanced stage, high nuclear grade, lymph node involvement, and sarcomatous differentiation (all P < 0.001). Low TC level was associated with poor recurrence-free or cancer-specific survival (CSS) in the entire cohort, whereas the significance of the association changed after stratification by disease stage and histologic subtype. Multivariate Cox regression analysis showed that preoperative TC, as a continuous or categorical variable, was an independent predictor of CSS. CONCLUSIONS: Preoperative low serum TC level was associated with aggressive tumor characteristics and poor CSS in patients with surgically treated RCC. Preoperative TC may provide additional guidance regarding the choice of therapeutic strategies to improve prognosis.
BACKGROUND: The prognostic implications of preoperative serum total cholesterol (TC) level in patients with renal cell carcinoma (RCC) remain poorly understood. We investigated the prognostic role of preoperative serum TC in patients with surgically treated RCC from a large, multi-institutional Korean collaboration. PATIENTS AND METHODS: A database of 3064 patients with RCC who underwent radical or partial nephrectomy between 1999 and 2011 at eight academic centers was analyzed. Preoperative serum TC levels were measured in fasting blood samples. RESULTS: Low preoperative serum TC level was associated with aggressive tumor characteristics, including large tumor size, advanced stage, high nuclear grade, lymph node involvement, and sarcomatous differentiation (all P < 0.001). Low TC level was associated with poor recurrence-free or cancer-specific survival (CSS) in the entire cohort, whereas the significance of the association changed after stratification by disease stage and histologic subtype. Multivariate Cox regression analysis showed that preoperative TC, as a continuous or categorical variable, was an independent predictor of CSS. CONCLUSIONS: Preoperative low serum TC level was associated with aggressive tumor characteristics and poor CSS in patients with surgically treated RCC. Preoperative TC may provide additional guidance regarding the choice of therapeutic strategies to improve prognosis.
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