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...

Full description

Saved in:
Bibliographic Details
Main Authors: 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
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Biomedicines
Subjects:
Online Access:https://www.mdpi.com/2227-9059/12/12/2898
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850050411659001856
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
id doaj-art-bbf1a3ae4a7b4f2e97e79415dd2855cf
institution DOAJ
issn 2227-9059
language English
publishDate 2024-12-01
publisher MDPI AG
record_format Article
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
work_keys_str_mv AT yaotetsai theprognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT minghsientsai theprognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT adarshkudva theprognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT andreadevito theprognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT chiahsuanlai theprognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT chuntaliao theprognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT chungjankang theprognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT yuanhsiungtsai theprognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT chengminghsu theprognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT ethanihuang theprognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT genghechang theprognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT mingshaotsai theprognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT kuhaofang theprognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT yaotetsai prognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT minghsientsai prognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT adarshkudva prognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT andreadevito prognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT chiahsuanlai prognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT chuntaliao prognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT chungjankang prognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT yuanhsiungtsai prognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT chengminghsu prognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT ethanihuang prognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT genghechang prognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT mingshaotsai prognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer
AT kuhaofang prognosticvalueofpreoperativetotalcholesterolinsurgicallytreatedoralcavitycancer