Clinical Implications of Preoperative Serum Total Cholesterol in Patients with Clear Cell Renal Cell Carcinoma

Objective: To investigate the clinical implication of preoperative serum total cholesterol (TC) level in patients with clear cell renal cell carcinoma (RCC).

Methods: The records of 364 patients with clear cell RCC who had undergone nephrectomy were retrospectively reviewed. The association among preoperative TC level, clinicopathologic factors, and oncological outcome in terms of cancer-specific survival (CSS) and recurrence-free survival period was analyzed by univariate and multivariate analyses.

Results: As a continuous variable, lower serum TC level was found to be significantly associated with male sex, symptomatic tumor, advanced TNM stage, higher nuclear grade, microscopic venous invasion, poor Eastern Cooperative Oncology Group Performance Status, larger tumor size, elevated C-reactive protein level, and lower hemoglobin level. Univariate analysis showed that relatively lower preoperative serum TC level was associated with lower recurrence-free survival (P = .040) and CSS (P <.001) rates. Multivariate analysis indicated that in addition to pT stage, M stage, nuclear grade, and Eastern Cooperative Oncology Group Performance Status, serum TC level (hazard ratio, 0.988 per mg/dL; 95% confidence interval, 0.980-0.998; P = .019) was an independent predictor of CSS.

Conclusion: Low preoperative serum TC level is associated with worse prognosis in patients with clear cell RCC. Consideration of preoperative serum TC level might thus provide additional prognostic information for patients with clear cell RCC.