Postoperative high-density lipoprotein cholesterol level: an independent prognostic factor for gastric cancer

Abstract

Objective: The relationship between serum lipids and prognosis of gastric cancer has not been confirmed. Our purpose in the study was to investigate the associations between preoperative and postoperative serum lipids level and prognosis in patients with gastric cancer.

Methods: A retrospective study was performed on 431 patients who received radical (R0) gastrectomy from 2011 to 2013. Preoperative and postoperative serum lipids level were recorded. Clinical-pathological characteristics, oncologic outcomes, disease-free survival (DFS) and overall survival (OS) were collected. The prognostic significance was determined by Kaplan-Meier analysis and Cox proportional hazards regression model.

Results: There was no significant difference in DFS and OS according to preoperative serum lipids level. Regarding postoperative serum lipids level, compared to normal high-density lipoprotein cholesterol (HDL-C), low postoperative HDL-C level indicated a shorter OS (hazard ratio: 1.76, 99% confidence interval: 1.31-2.38; P=0.000) and a shorter DFS (hazard ratio: 2.06, 99% confidence interval: 1.55-2.73; P=0.000). However, other postoperative serum lipid molecules were not associated with DFS and OS.

Conclusion: Postoperative HDL-C might be an independent prognostic factor of gastric cancer.

Keywords: disease-free survival; gastric cancer; overall survival; postoperative serum lipids; preoperative serum lipids; prognosis.

Figure 1

Overall Survival in preoperative serum lipid. Overall Survival of patients grouped by serum lipid levels before surgery, no significant differences were observed at all levels.

Figure 2

Overall Survival in postoperative serum lipid. There were significant differences in the low HDL and normal HDL groups (P=0.000). However, no significant differences were observed in other groups.