title: Serum low-density lipoprotein levels correlate with survival in advanced stage epithelial ovarian cancers.
abstract: OBJECTIVE
  Recent data suggest patients with epithelial ovarian cancers on statin therapy have improved survival. We have hypothesized that statins influence ovarian cancer outcome through alteration of lipoprotein profiles, and sought to determine correlations between lipoprotein levels and survival in women with advanced stage disease.
  
  
  METHODS
  After IRB approval, we identified patients with stage IIIC/IV epithelial ovarian cancer with banked prediagnostic fasting serum. Serum was assayed for levels of total cholesterol (TC), high-density lipoprotein (HDL), and triglycerides (TG). LDL was calculated by subtraction of TG/5 and HDL from TC. Data were examined using Fisher's exact, Kaplan-Meier, and Cox regression analyses.
  
  
  RESULTS
  One hundred thirty-two patients were studied. Twenty-six percent of patients had elevated LDL; 18% had elevated TC; 32% had elevated TG; and 48% had elevated HDL. No univariate associations were identified between elevated TC, HDL, TG, LDL and age, stage IV disease, high grade, or optimal cytoreduction. Median progression-free survival for patients with normal LDL levels was 27 months, compared to 12 months for patients with elevated LDL (p=0.0004). Overall disease-specific survival was longer for patients with normal LDL levels (59 months) compared to those with elevated LDL (51 months, p=0.04). Multivariate analysis indicated that LDL retained significance as an independent predictor of survival, after controlling for age, stage, grade, and suboptimal cytoreduction (p=0.003).
  
  
  CONCLUSIONS
  These data suggest LDL is a significant predictor of clinical outcome, and warrant the further study of lipoproteins and statins on epithelial ovarian cancer biology.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cedars-Sinai Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90048, USA. Andrew.Li@cshs.org
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Li
authors.forename: R Geoffrey
authors.initials: RG
authors.lastname: Elmore
authors.forename: Ida Yii-der
authors.initials: IY
authors.lastname: Chen
authors.forename: Beth Y
authors.initials: BY
authors.lastname: Karlan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002784:Cholesterol / Q000097:blood; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood*; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood* / Q000473:pathology*; D014280:Triglycerides / Q000097:blood
chemical_list: D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D014280:Triglycerides; D002784:Cholesterol