The association of preoperative serum free fatty acid with the survival in breast cancer patients

Abstract

Background Several studies have analyzed the association between serum free fatty acid (FFA) and several types of cancer. However, the role of preoperative serum FFA and breast cancer (BC) prognosis remains largely unclear. This study aimed to elucidate the specific relationship between FFA and BC outcomes. Methods A retrospective review was conducted on 4133 breast cancer patients admitted to Sun Yat-sen Memorial Hospital from January 2015 to October 2021. Restricted cubic splines and multivariate Cox regression analyses were used to assess the relationship between preoperative serum FFA and overall survival (OS) in BC patients. The hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated. Results Restricted cubic spline analysis revealed a U-shaped relationship between preoperative serum FFA levels and OS after adjusting for other variables. According to the cutoff points of FFA, multivariate Cox regression analyses showed that patients with low FFA levels (≤ 250µmol/L) had higher rates of all-cause mortality and cancer-specific mortality compared to patients with high FFA levels (250–715µmol/L) in total population and those with a BMI of 18.5 to 24.0 kg/m2. Conclusion A nonlinear U-shaped association was identified between preoperative serum FFA levels and the survival in BC patients, with lower FFA levels associated with worse OS.