Preoperative serum total cholesterol is a predictor of prognosis in patients with renal cell carcinoma: a meta-analysis of observational studies

Abstract

Purpose: Several studies have demonstrated the strong correlation between the levels of preoperative serum total cholesterol (TC) and the survival of patients with surgically treated renal cell carcinoma (RCC). However, this association remains controversial. We performed a meta-analysis of published reports to evaluate the prognostic signifi cance of the preoperative serum TC levels for patients with surgically treated RCC. Material and Methods: The databases from MEDLINE (via PubMed), Embase, Web of Science and Cochrane Library were systematically searched to identify the eligible studies published before August 2019. Multivariate adjusted hazard ratios (HRs) with 95% confi dence intervals (CIs) were calculated through inverse variance by using random-effects models. Results: Nine cohort studies comprising 15.609 patients were identifi ed. Low preoperative serum TC levels were associated with poor cancer-specifi c survival (CSS; HR=0.98, 95% CI: 0.97-0.99; P=0.005; I 2 =74.2%) and progression-free survival (PFS; HR=0.69, 95% CI: 0.49-0.98; P=0.036; I 2 =80%) in patients with surgically treated RCC. However, no signifi cant association was observed between low preoperative serum TC levels and shorter overall survival (HR=0.93, 95% CI: 0.87-1.00; P=0.057; I 2 =86.2%). Sensitivity analyses validated the reliability and rationality of the results. Conclusions: Preoperative serum TC level is an independent poor prognostic factor for patients with surgically treated RCC, with lower levels associated with worse CSS and PFS. Hence, this parameter may provide additional guidance in the selection of therapeutic strategies to improve prognosis, considering that cholesterol is a broadly applied routine marker in clinical practice.

Controlling Nutritional Status (CONUT) score as a predictive marker for short-term complications following gastrectomy of gastric cancer: a retrospective study

“…Multivariate analysis revealed that the CONUT rather that albumin level was correlated with postoperative short-term complications. Secondly, total cholesterol level, representing lipid metabolism, has been found to be related to tumor progression and overall survival in various kinds of cancer [ 37 , 38 ]. Several studies suggested that a low cholesterol level might affect the antioxidant reserve and inflammatory response [ 39 , 40 ].…”

A Machine Learning-Modified Novel Nomogram to Predict Perioperative Blood Transfusion of Total Gastrectomy for Gastric Cancer

“…Hypoproteinemia is often associated with anastomotic leaks, infections, and thoracoabdominal effusion ( 29 – 31 ). Total cholesterol level is often related to metabolism, antioxidant reserve, and inflammatory response ( 32 – 34 ). Lymphocytes are an important part of the human immune response system, helping to fight tumors by inhibiting the proliferation and migration of cancer cells ( 35 ).…”

The role of immunotherapy in advanced renal cell carcinoma

“…One of the theories attempt to explain this condition, defends that PD-L1 is a dynamic marker that can be regulated by cytokines induced by local inflammation, thus the expression of PD-L1 within the tumour can change over time and according to the microenvironment conditions (59). Other biomarkers, such as the level of total cholesterol (TC) and the expression of sodium--dependent glucose transporter 2 (SGLT-2), have been studied in non-immunological therapies (63,64). Future studies might focus on the validation of these biomarkers in immunotherapy.…”