title: Predictive value of chemotherapy-related high-density lipoprotein cholesterol (HDL) elevation in patients with colorectal cancer receiving adjuvant chemotherapy: an exploratory analysis of 851 cases.
abstract: BACKGROUND
  The phenomenon of chemotherapy-related lipid alterations has been reported based on a small number of patients and varies among different cancers. However, little is known about these alterations in colorectal cancer (CRC) patients.
  
  
  RESULTS
  Patients in cohort 1, but not in cohort 2, exhibited significantly increased cholesterol, triglyceride, HDL-C, and ApoA-I levels, and decreased LDL-C and ApoB levels after adjuvant chemotherapy. Patients with chemotherapy-related HDL-C elevation exhibited better 3-year DFS (84.5% vs. 73%, P = 0.001) and 7-year OS (82% vs. 70%, P = 0.002) than those without. Similarly, the 3-year DFS (83.3% vs. 77.6%, P = 0.008) and 7-year OS (81% vs. 74.6%, P = 0.040) were superior in chemotherapy-related ApoA-I elevation patients. However, only HDL-C elevation remained an independent prognostic value in the multivariate Cox model.
  
  
  METHODS
  Eight hundred fifty-one CRC patients with curative-intent resection were retrospectively analyzed. Six hundred sixty-seven receiving fluoropyrimidine-based adjuvant chemotherapy for more than 3 months were enrolled in cohort 1. The lipid alterations before and after chemotherapy were studied. Simultaneously, 184 patients not treated with chemotherapy (cohort 2) were included as a control for the comparisons of lipids alterations within 1 month after resection and at half-year follow-up. Furthermore, these significant alterations were investigated with respect to the prognostic value of disease-free survival (DFS) and overall survival (OS). An internal validation was performed.
  
  
  CONCLUSIONS
  We observed significant changes in the levels of various lipids in CRC patients receiving adjuvant chemotherapy. Furthermore, chemotherapy-related HDL-C elevation was determined to be an independent prognostic indicator for superior DFS and OS.
authors.affiliation: Sate Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China.|Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Sate Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China.|Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.
authors.forename: Zhi-Qiang
authors.initials: ZQ
authors.lastname: Wang
authors.affiliation: Sate Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China.|Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.
authors.forename: Feng-Hua
authors.initials: FH
authors.lastname: Wang
authors.affiliation: Department of Medical Oncology, The Second Affiliated Hospital of Kunming Medical University, Kunming, P.R. China.
authors.forename: Xue-Fen
authors.initials: XF
authors.lastname: Lei
authors.affiliation: Sate Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China.|Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.
authors.forename: Shu-Mei
authors.initials: SM
authors.lastname: Yan
authors.affiliation: Sate Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China.|Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.
authors.forename: De-Shen
authors.initials: DS
authors.lastname: Wang
authors.affiliation: Sate Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China.|Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.
authors.forename: Fei
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Sate Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China.|Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.
authors.forename: Rui-Hua
authors.initials: RH
authors.lastname: Xu
authors.affiliation: Department of Gastroenterology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P.R. China.
authors.forename: Ling-Yun
authors.initials: LY
authors.lastname: Wang
authors.affiliation: Sate Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China.|Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.
authors.forename: Yu-Hong
authors.initials: YH
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000494:pharmacology*; D016632:Apolipoprotein A-I / Q000378:metabolism; D017024:Chemotherapy, Adjuvant; D008076:Cholesterol, HDL / Q000378:metabolism*; D015179:Colorectal Neoplasms / Q000097:blood* / Q000188:drug therapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: C505693:APOA1 protein, human; D000970:Antineoplastic Agents; D016632:Apolipoprotein A-I; D008076:Cholesterol, HDL
keywords: chemotherapy; colorectal cancer; high-density lipoprotein cholesterol; prognosis