Associations between pre-operative cholesterol levels with long-term survival after colorectal cancer surgery: a nationwide propensity score-matched cohort study.

IF 2.5 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY International Journal of Colorectal Disease Pub Date : 2024-10-10 DOI:10.1007/s00384-024-04735-3
Lea Löffler, Maliha Mashkoor, Ismail Gögenur, Mikail Gögenur
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Abstract

Purpose: Altered lipid metabolism frequently occurs in patients with solid cancers and dyslipidemia has been associated with poorer outcomes in patients with colorectal cancer. This study sought to investigate whether cholesterol levels are associated with clinical outcomes and can serve as survival predictors.

Methods: We conducted a retrospective cohort study with Danish patients diagnosed with colorectal cancer who had surgery with curative intent for UICC stages I to III between 2015 and 2020. Using propensity score adjustment, we matched patients in a 1:1 ratio to examine the impact of total cholesterol (TC) > 4 mmol/L vs. ≤ 4 mmol/L within 365 days prior to surgery on overall survival (OS) and disease-free survival (DFS).

Results: A total of 3443 patients were included in the study. Median follow-up time was 3.8 years. Following propensity score matching, 1572 patients were included in the main analysis. There was no statistically significant difference in OS or DFS between patients with TC > 4 mmol/L compared with TC ≤ 4 mmol/L (HR: 0.82, 95% CI, 0.65-1.03, HR: 0.87, 95% CI, 0.68-1.12, respectively.). A subgroup analysis investigating TC > 4 mmol/L as well as low-density lipoprotein (LDL) > 3 mmol/L found a significant correlation with OS (HR: 0.74, 95% CI, 0.54-0.99).

Conclusion: TC levels alone were not associated with OS or DFS in patients with colorectal cancer. Interestingly, higher TC and LDL levels were linked to better overall survival, suggesting the need for further exploration of cholesterol's role in colorectal cancer.

Trial registration: Not applicable.

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术前胆固醇水平与结直肠癌术后长期生存率的关系:一项全国范围的倾向得分匹配队列研究。
目的:实体瘤患者的脂质代谢经常发生改变,而血脂异常与结直肠癌患者较差的预后有关。本研究旨在探讨胆固醇水平是否与临床预后相关,并可作为生存预测指标:我们进行了一项回顾性队列研究,研究对象是在 2015 年至 2020 年期间确诊为结直肠癌并接受了 UICC I 期至 III 期治愈性手术的丹麦患者。通过倾向评分调整,我们将患者按1:1的比例进行配对,以研究手术前365天内总胆固醇(TC)> 4 mmol/L与≤ 4 mmol/L对总生存期(OS)和无病生存期(DFS)的影响:研究共纳入了 3443 例患者。中位随访时间为 3.8 年。经过倾向评分匹配,1572 名患者被纳入主要分析。TC>4毫摩尔/升的患者与TC≤4毫摩尔/升的患者相比,在OS或DFS方面没有明显的统计学差异(HR:0.82,95% CI,0.65-1.03;HR:0.87,95% CI,0.68-1.12)。对总胆固醇>4毫摩尔/升以及低密度脂蛋白(LDL)>3毫摩尔/升进行的亚组分析发现,总胆固醇与OS有显著相关性(HR:0.74,95% CI,0.54-0.99):结论:单纯的总胆固醇水平与结直肠癌患者的OS或DFS无关。有趣的是,较高的总胆固醇和低密度脂蛋白水平与较好的总生存率有关,这表明有必要进一步探讨胆固醇在结直肠癌中的作用:试验注册:不适用。
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来源期刊
CiteScore
4.90
自引率
3.60%
发文量
206
审稿时长
3-8 weeks
期刊介绍: The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies. The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.
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