The Effect of Preoperative Apolipoprotein A-I on the Prognosis of Surgical Renal Cell Carcinoma

Abstract

The prognostic value of serum lipid-profile in renal cell cancer (RCC) remains unknown. The purpose of the study is to explore the association between the serum lipid-profile and RCC patients.The levels of preoperative serum lipid-profile (including cholesterol, triglycerides, high-density lipoprotein-cholesterol [HDL-C], low-density lipoprotein-cholesterol [LDL-C], apolipoprotein A-I [ApoA-I], and apolipoprotein B [ApoB]) were retrospectively performed in 786 patients with RCC. The cutoff values of the lipids were determined by the receiver-operating characteristic (ROC) curve analysis. Univariate and multivariate Cox regression analyses were performed to investigate the prognostic value of serum lipids in RCC.Combined ROC analysis and univariate and multivariate Cox regression analyses, for overall survival (OS), revealed patients with low ApoA-I (<1.04) had significantly lower OS than the high ApoA-I (≥1.04) group (multivariate Cox regression analyses, hazard ratio [HR], 0.57; P = 0.003). Not only in the whole RCC cohort but also in the subgroups stratified according to the pT1-2 (P = 0.002), pN0 (P < 0.001), and pM0 (P = 0.001) status, respectively. Moreover, in the 755 patients with nonmetastasis, the low ApoA-I group was also associated with shortened disease-free survival (DFS) time compared to the high ApoA-I group (multivariate Cox regression analyses, HR, 0.65; P = 0.033). However, the other lipids were not independent prognostic factors for surgical RCC.An elevated level of preoperative ApoA-I was demonstrated to be related with better survival in patients with surgical RCC. Measuring the preoperative ApoA-I might be a simple way for finding the poor prognostic patients who should enrolled in further clinical trials and management.

Association Between Pretreatment Serum Apolipoprotein A1 and Prognosis of Solid Tumors in Chinese Population: A Systematic Review and Meta-Analysis

“…The included studies originated from Guangdong [27, 29-36, 39], Beijing [28], and Shanghai [37, 38]. A total of 8052 patients diagnosed with several kinds of cancers were including.…”

“…Therefore, 14 cohorts were enrolled, and the sample sizes ranged from 99 to 1927. The outcomes of OS were reported in all 14 cohorts, and the end points of DFS were presented in 4 cohorts [30-32, 36]. Nine cohorts recruited patients with all disease stages (stage I – IV) [27, 29, 30, 32, 34-37], three cohorts included patients with advanced stage (including stage IV [33, 39], and stage IIB – IV [38]), one cohort contained patients with stage I – III [31], and the other one reported the data of patient with stage Tis – T1 [28].…”

“…A total of 8052 patients diagnosed with several kinds of cancers were including. These cancers included gastric cancer (GC) [27], bladder cancer [28], non small cell lung cancer (NSCLC) [29, 38], nasopharyngeal carcinoma (NPC) [30, 39], breast cancer [31, 32], colorectal cancer (CRC) [33], upper tract urothelial carcinoma (UTUC) [34], esophageal squamous cell cancer (ESCC) [35], renal cell carcinoma (RCC) [36], and hepatocellular carcinoma (HCC) [37]. Eleven studies were published in English [27-33, 35-37, 39], whereas the other two studies were in Chinese [34, 39].…”

Prognostic value of the serum apolipoprotein B to apolipoprotein A-I ratio in metastatic colorectal cancer patients

“…A recent retrospective study reported that low serum ApoA-I levels were associated with advanced T class and TNM stage and systemic inflammation biomarkers in CRC. All of these findings indicate that serum ApoA-I may participate in multiple processes in the occurrence and development of cancers [19,20,[29][30][31].…”

Preoperative serum total cholesterol is a predictor of prognosis in patients with renal cell carcinoma: a meta-analysis of observational studies

“…The basic clinical characteristics of the enrolled studies (12)(13)(14)(15)(21)(22)(23)(24)(25) are provided in Table 1. For the study design, the nine included studies were retrospective cohorts and published from 2014 to 2019.…”