The Prognostic Value of Preoperative Total Cholesterol in Surgically Treated Oral Cavity Cancer
Background: With growing evidence linking lipid profile changes to tumor development and cancer prognosis, we investigated the prognostic significance of preoperative serum total cholesterol (TC) levels in patients with oral cavity squamous cell carcinoma (OSCC) undergoing surgical treatment. Method...
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2024-12-01
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| author | Yao-Te Tsai Ming-Hsien Tsai Adarsh Kudva Andrea De Vito Chia-Hsuan Lai Chun-Ta Liao Chung-Jan Kang Yuan-Hsiung Tsai Cheng-Ming Hsu Ethan I. Huang Geng-He Chang Ming-Shao Tsai Ku-Hao Fang |
| author_facet | Yao-Te Tsai Ming-Hsien Tsai Adarsh Kudva Andrea De Vito Chia-Hsuan Lai Chun-Ta Liao Chung-Jan Kang Yuan-Hsiung Tsai Cheng-Ming Hsu Ethan I. Huang Geng-He Chang Ming-Shao Tsai Ku-Hao Fang |
| author_sort | Yao-Te Tsai |
| collection | DOAJ |
| description | Background: With growing evidence linking lipid profile changes to tumor development and cancer prognosis, we investigated the prognostic significance of preoperative serum total cholesterol (TC) levels in patients with oral cavity squamous cell carcinoma (OSCC) undergoing surgical treatment. Methods: We conducted a retrospective observational study involving 310 patients with primary OSCC who received surgery at our hospital from January 2009 to December 2018. Receiver operating characteristic curve analysis was performed to determine the optimal preoperative TC cutoff value, with the Youden Index employed as the optimization criterion to maximize the sum of sensitivity and specificity. Variables with <i>p</i> < 0.1 in the univariable analysis were included in the multivariable Cox regression model, and stepwise selection was used to identify the optimal subset of prognostic factors for overall survival (OS) and disease-free survival (DFS). Results: An optimal TC cutoff of 157 mg/dL was established. Patients with TC < 157 mg/dL exhibited significantly lower 5-year rates of OS and DFS (<i>p</i> < 0.001 and <i>p</i> = 0.006, respectively). Multivariable analysis confirmed that TC < 157 mg/dL represented an independent prognostic factor for reduced OS and DFS rates. Subgroup analyses reinforced the consistent prognostic significance of TC. We also constructed a nomogram (concordance index: 0.74) to provide personalized OS predictions, enhancing the clinical utility of TC. Conclusions: Preoperative TC appears to be a significant prognostic factor for OS and DFS after OSCC surgery. Routine TC assessment facilitates the development of nomograms for personalized survival predictions, supports clinicians in tailoring treatment strategies, and guides nutritional or metabolic interventions to enhance patient outcomes. Further multicenter prospective studies are needed to validate our findings. |
| format | Article |
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| institution | DOAJ |
| issn | 2227-9059 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
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| series | Biomedicines |
| spelling | doaj-art-bbf1a3ae4a7b4f2e97e79415dd2855cf2025-08-20T02:53:27ZengMDPI AGBiomedicines2227-90592024-12-011212289810.3390/biomedicines12122898The Prognostic Value of Preoperative Total Cholesterol in Surgically Treated Oral Cavity CancerYao-Te Tsai0Ming-Hsien Tsai1Adarsh Kudva2Andrea De Vito3Chia-Hsuan Lai4Chun-Ta Liao5Chung-Jan Kang6Yuan-Hsiung Tsai7Cheng-Ming Hsu8Ethan I. Huang9Geng-He Chang10Ming-Shao Tsai11Ku-Hao Fang12Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613016, TaiwanCollege of Medicine, Chang Gung University, Taoyuan 330036, TaiwanDepartment of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal 576104, IndiaEar Nose Throat (ENT) Unit, Department of Surgery, Forli Hospital Health Local Agency of Romagna, 47121 Forli, ItalyCollege of Medicine, Chang Gung University, Taoyuan 330036, TaiwanCollege of Medicine, Chang Gung University, Taoyuan 330036, TaiwanCollege of Medicine, Chang Gung University, Taoyuan 330036, TaiwanCollege of Medicine, Chang Gung University, Taoyuan 330036, TaiwanDepartment of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613016, TaiwanDepartment of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613016, TaiwanDepartment of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613016, TaiwanDepartment of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613016, TaiwanCollege of Medicine, Chang Gung University, Taoyuan 330036, TaiwanBackground: With growing evidence linking lipid profile changes to tumor development and cancer prognosis, we investigated the prognostic significance of preoperative serum total cholesterol (TC) levels in patients with oral cavity squamous cell carcinoma (OSCC) undergoing surgical treatment. Methods: We conducted a retrospective observational study involving 310 patients with primary OSCC who received surgery at our hospital from January 2009 to December 2018. Receiver operating characteristic curve analysis was performed to determine the optimal preoperative TC cutoff value, with the Youden Index employed as the optimization criterion to maximize the sum of sensitivity and specificity. Variables with <i>p</i> < 0.1 in the univariable analysis were included in the multivariable Cox regression model, and stepwise selection was used to identify the optimal subset of prognostic factors for overall survival (OS) and disease-free survival (DFS). Results: An optimal TC cutoff of 157 mg/dL was established. Patients with TC < 157 mg/dL exhibited significantly lower 5-year rates of OS and DFS (<i>p</i> < 0.001 and <i>p</i> = 0.006, respectively). Multivariable analysis confirmed that TC < 157 mg/dL represented an independent prognostic factor for reduced OS and DFS rates. Subgroup analyses reinforced the consistent prognostic significance of TC. We also constructed a nomogram (concordance index: 0.74) to provide personalized OS predictions, enhancing the clinical utility of TC. Conclusions: Preoperative TC appears to be a significant prognostic factor for OS and DFS after OSCC surgery. Routine TC assessment facilitates the development of nomograms for personalized survival predictions, supports clinicians in tailoring treatment strategies, and guides nutritional or metabolic interventions to enhance patient outcomes. Further multicenter prospective studies are needed to validate our findings.https://www.mdpi.com/2227-9059/12/12/2898oral squamous cell carcinomatotal cholesterolbiomarkersprognosisnomogram |
| spellingShingle | Yao-Te Tsai Ming-Hsien Tsai Adarsh Kudva Andrea De Vito Chia-Hsuan Lai Chun-Ta Liao Chung-Jan Kang Yuan-Hsiung Tsai Cheng-Ming Hsu Ethan I. Huang Geng-He Chang Ming-Shao Tsai Ku-Hao Fang The Prognostic Value of Preoperative Total Cholesterol in Surgically Treated Oral Cavity Cancer Biomedicines oral squamous cell carcinoma total cholesterol biomarkers prognosis nomogram |
| title | The Prognostic Value of Preoperative Total Cholesterol in Surgically Treated Oral Cavity Cancer |
| title_full | The Prognostic Value of Preoperative Total Cholesterol in Surgically Treated Oral Cavity Cancer |
| title_fullStr | The Prognostic Value of Preoperative Total Cholesterol in Surgically Treated Oral Cavity Cancer |
| title_full_unstemmed | The Prognostic Value of Preoperative Total Cholesterol in Surgically Treated Oral Cavity Cancer |
| title_short | The Prognostic Value of Preoperative Total Cholesterol in Surgically Treated Oral Cavity Cancer |
| title_sort | prognostic value of preoperative total cholesterol in surgically treated oral cavity cancer |
| topic | oral squamous cell carcinoma total cholesterol biomarkers prognosis nomogram |
| url | https://www.mdpi.com/2227-9059/12/12/2898 |
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