Prognostic value of hypocholesterolemia in patients with gastric cancer

BackgroundAccording to previous studies, low serum total cholesterol (TC) is associated with higher cancer incidence and mortality. However, the prognostic implications of preoperative TC in patients with gastric cancer (GC) remain to be determined.MethodsA total of 1251 patients with GC, who underwent radical gastrectomy between 2005 and 2008, were recruited. Propensity score weighting (PSW) based on a generalized boosted method (GBM) was used to control for selection bias.ResultsAfter balancing the preoperative and operative covariates, low TC was associated with high incidence of complications (severe complication rate: 15.2% (Low TC) vs. 4.7% (Normal TC) vs 5.5% (High TC); p = 0.004). In multivariable analysis, lowering TC was associated with poor OS and RFS in weighted population. [OS: hazard ratio (HR) = 0.92; 95% CI = 0.867–0.980; P = 0.009 and RFS: HR = 0.93; 95% CI = 0.873–0.988; P = 0.02].ConclusionsPreoperative TC is a useful predictor of postoperative survival and postoperative complications in patients with stage I–III GC and may help to identify high-risk patients for rational therapy, including nutritional support, and timely follow-up.