Cholesterol Linked to Renal Cell Cancer Prognosis

Postoperative prognosis for renal cell carcinoma patients linked to preoperative cholesterol levels

medwireNews: Serum cholesterol levels significantly predict the survival of patients undergoing total or partial nephrectomy for renal cell carcinoma (RCC), say Austrian researchers.

In multivariate analysis, RCC patients with a high serum cholesterol level, defined as at least 161.5 mg/dL, had a 43% reduced risk of cancer-specific death compared with patients with lower cholesterol levels, with a significant 6% decrease in the risk of death for each 10 mg/dL increase in cholesterol.

And for patients with clinically localised disease, a high cholesterol level gave a 63% decrease in the risk of cancer-specific death, with a significant 10% decrease in risk per 10 mg/dL increase.

Tobias Klatte and co-workers, from the Medical University of Vienna, measured cholesterol levels in 867 RCC patients, including 750 with clinically localised disease (T1–3N0/+M0), and found no significant difference in the serum concentrations of patients with clear cell, papillary or chromophobe subtypes.

“Data may therefore suggest that the observed effects may in part be patient- and not tumour related, as the subtypes are commonly associated with stage and grade of disease”, the researchers comment.

However, serum cholesterol levels were significantly and negatively associated with increasing T stage, tumour size, nuclear grade and the presence of lymph node metastasis, distant metastasis and histological tumour necrosis.

“As cholesterol is a broadly available routine marker, its use may provide a meaningful adjunct in clinical practice”, the team suggests in BJU International.

Although RCC cells store high levels of lipids, the relationship between serum and tumour cholesterol levels is unknown. Noting that cholesterol is the precursor for steroid hormones including glucocorticoids and sex hormones, the researchers suggest that serum levels of these should be examined in future studies.

The impact of statin medications and cholesterol changes on RCC outcome should also be investigated, the team recommends.

Reference

de Martino M, Leitner C, Seemann C, et al. Preoperative serum cholesterol is an independent prognostic factor for patients with renal cell carcinoma. BJU Int 2014; First published online 12 June. DOI: 10.1111/bju.12767

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