title: Correlation between pretreatment serum LDL-cholesterol levels and prognosis in nasopharyngeal carcinoma patients.
abstract: OBJECTIVE
  To investigate the correlations between long-term survival outcomes in patients with nasopharyngeal carcinoma (NPC) and pretreatment serum low-density lipoprotein cholesterol (LDL-C) levels.
  
  
  METHODS
  Between January 2008 and December 2011, 935 patients with newly diagnosed NPC who were treated with intensity-modulated radiation therapy were included in this retrospective clinical analysis. Patients were divided into two groups based on pretreatment LDL-C levels: normal LDL-C (≤3.64 mmol/L; n=816) and elevated LDL-C (>3.64 mmol/L; n=119). Associations between pretreatment LDL-C levels and treatment outcome were analyzed by univariate and multivariate analyses.
  
  
  RESULTS
  The overall patient follow-up rate was 95.1%, and 726 patients received more than 5 years of follow-up. Five-year overall survival (OS), local control (LC), and distant metastasis-free survival (DMFS) rates of the entire patient population were 87.1%, 91.1%, and 87.2%, respectively. Rates of 5-year OS, LC, and DMFS for the elevated versus normal LDL-C groups were 77.0% vs 89.1% (P<0.001), 85.8% vs 91.9% (P=0.041), and 81.1% vs 88.1% (P=0.038), respectively. Compared with normal LDL-C levels, elevated LDL-C levels were identified as an independent prognostic factor of a poorer OS (hazard ratio [HR] =2.171; 95% confidence interval [CI] =1.424-3.309), LC rate (HR =1.762; 95% CI =1.021-3.942), and DMFS (HR =1.594; 95% CI =1.003-2.532).
  
  
  CONCLUSIONS
  This study found that elevated pretreatment LDL-C levels are negative prognostic indicators of NPC. Elevated LDL-C levels may be useful indicators of locoregional control and distant metastasis in NPC patients.
authors.affiliation: Department of Head and Neck Cancer Radiotherapy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, People's Republic of China.
authors.forename: Qiu
authors.initials: Q
authors.lastname: Tang
authors.affiliation: Department of Head and Neck Cancer Radiotherapy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, People's Republic of China.
authors.forename: Qiao-Ying
authors.initials: QY
authors.lastname: Hu
authors.affiliation: Department of Head and Neck Cancer Radiotherapy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, People's Republic of China.
authors.forename: Yong-Feng
authors.initials: YF
authors.lastname: Piao
authors.affiliation: Department of Head and Neck Cancer Radiotherapy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, People's Republic of China.
authors.forename: Yong-Hong
authors.initials: YH
authors.lastname: Hua
keywords: LDL-cholesterol; nasopharyngeal carcinoma; prognosis