title: Clinical implications of preoperative serum total cholesterol in patients with clear cell renal cell carcinoma.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Urology, Tokyo Medical University, Tokyo, Japan. Electronic address: yoshio-o@tokyo-med.ac.jp.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ohno
authors.affiliation: Department of Urology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Nakashima
authors.affiliation: Department of Urology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nakagami
authors.affiliation: Department of Urology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Gondo
authors.affiliation: Department of Urology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ohori
authors.affiliation: Department of Urology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Hatano
authors.affiliation: Department of Urology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Tachibana
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000097:blood* / Q000601:surgery*; D002784:Cholesterol / Q000097:blood*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000097:blood* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D002784:Cholesterol