Prognostic value of perioperative serum low-density lipoprotein cholesterol level for postoperative prognosis of pancreatic cancer: a retrospective study.
Level 3 - non-randomized controlled study
Retrospective cohort prognostic study
PubMed 37391827 · doi:10.1186/s12944-023-01851-x
What was done
Data from pancreatic cancer patients who underwent surgery between January 2015 and December 2021 were retrospectively analyzed. Receiver operating characteristic (ROC) curves evaluated perioperative serum LDL-c at multiple timepoints against 1-year postoperative survival to determine an optimal cut-off value. Patients were categorized into low and high LDL-c groups, and disease-free survival (DFS) and overall survival (OS) were evaluated using univariate and multivariate analyses.
What was found
The ROC area under the curve for serum LDL-c at 4 weeks postoperatively was 0.669 (95% CI: 0.581–0.757) with an optimal cut-off of 1.515 mmol/L. - Median DFS was 9 months in the low LDL-c group versus 16 months in the high LDL-c group (1-, 2-, and 3-year DFS: 42.6%, 21.1%, 11.7% vs. 60.2%, 35.3%, 26.2%; P = 0.005). - Median OS was 12 months in the low LDL-c group versus 22 months in the high LDL-c group (1-, 2-, and 3-year OS: 46.8%, 22.6%, 15.8% vs. 77.9%, 46.8%, 30.4%; P = 0.004). - Multivariate analysis confirmed low 4-week postoperative LDL-c as an independent predictor of early recurrence and worse survival.
Why it matters
Postoperative serum LDL-c at 4 weeks may serve as an accessible, routine blood-based prognostic biomarker to help stratify long-term outcomes following pancreatic cancer resection.
Limits
The total sample size is not stated in the abstract. The study is a single-center retrospective analysis susceptible to selection bias and unmeasured confounding (such as nutritional status, cachexia, or adjuvant therapy regimens). Predictive discrimination was modest (AUC 0.669).