Key result
Pre-operative total cholesterol > 4 mmol/L was not significantly associated with overall survival compared to ≤ 4 mmol/L in patients undergoing colorectal cancer surgery (HR 0.82; 95% CI 0.65-1.03).
Why the study?
Does pre-operative total cholesterol > 4 mmol/L improve overall survival and disease-free survival in patients undergoing curative surgery for colorectal cancer?
Cohort (n=3,443)
Yes
Does pre-operative total cholesterol > 4 mmol/L improve overall survival and disease-free survival in patients undergoing curative surgery for colorectal cancer?
Answers are grounded in this paper and cite their sources.
Pre-operative total cholesterol levels alone were not significantly associated with overall or disease-free survival in colorectal cancer patients, though a subgroup with high TC and LDL showed better overall survival.
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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Löffler et al. (2024) conducted a cohort in colorectal cancer (n=3,443). Total cholesterol > 4 mmol/L within 365 days prior to surgery vs. Total cholesterol ≤ 4 mmol/L was evaluated on overall survival (OS) (HR 0.82, 95% CI 0.65-1.03). Pre-operative total cholesterol > 4 mmol/L was not significantly associated with overall survival compared to ≤ 4 mmol/L in patients undergoing colorectal cancer surgery (HR 0.82; 95% CI 0.65-1.03).
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