Clinical Research Papers:

Predictive value of chemotherapy-related high-density lipoprotein cholesterol (HDL) elevation in patients with colorectal cancer receiving adjuvant chemotherapy: an exploratory analysis of 851 cases

Yun Wang, Zhi-qiang Wang, Feng-hua Wang, Xue-fen Lei, Shu-mei Yan, De-shen Wang, Fei Zhang, Rui-hua Xu, Ling-yun Wang and Yu-hong Li _

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Oncotarget. 2016; 7:57290-57300. https://doi.org/10.18632/oncotarget.10145

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Yun Wang1,2,*, Zhi-qiang Wang1,2,*, Feng-hua Wang1,2, Xue-fen Lei3, Shu-mei Yan1,4, De-shen Wang1,2, Fei Zhang1,2, Rui-hua Xu1,2, Ling-yun Wang5 and Yu-hong Li1,2

1 Sate Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P.R. China

2 Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China

3 Department of Medical Oncology, The Second Affiliated Hospital of Kunming Medical University, Kunming, P.R. China

4 Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China

5 Department of Gastroenterology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P.R. China

* These authors have contributed equally to this work

Correspondence to:

Yu-hong Li, email:

Ling-yun Wang, email:

Keywords: colorectal cancer, high-density lipoprotein cholesterol, chemotherapy, prognosis

Received: March 03, 2016 Accepted: June 03, 2016 Published: June 17, 2016


Background: The phenomenon of chemotherapy-related lipid alterations has been reported based on a small number of patients and varies among different cancers. However, little is known about these alterations in colorectal cancer (CRC) patients.

Results: Patients in cohort 1, but not in cohort 2, exhibited significantly increased cholesterol, triglyceride, HDL-C, and ApoA-I levels, and decreased LDL-C and ApoB levels after adjuvant chemotherapy. Patients with chemotherapy-related HDL-C elevation exhibited better 3-year DFS (84.5% vs. 73%, P = 0.001) and 7-year OS (82% vs. 70%, P = 0.002) than those without. Similarly, the 3-year DFS (83.3% vs. 77.6%, P = 0.008) and 7-year OS (81% vs. 74.6%, P = 0.040) were superior in chemotherapy-related ApoA-I elevation patients. However, only HDL-C elevation remained an independent prognostic value in the multivariate Cox model.

Methods: Eight hundred fifty-one CRC patients with curative-intent resection were retrospectively analyzed. Six hundred sixty-seven receiving fluoropyrimidine-based adjuvant chemotherapy for more than 3 months were enrolled in cohort 1. The lipid alterations before and after chemotherapy were studied. Simultaneously, 184 patients not treated with chemotherapy (cohort 2) were included as a control for the comparisons of lipids alterations within 1 month after resection and at half-year follow-up. Furthermore, these significant alterations were investigated with respect to the prognostic value of disease-free survival (DFS) and overall survival (OS). An internal validation was performed.

Conclusion: We observed significant changes in the levels of various lipids in CRC patients receiving adjuvant chemotherapy. Furthermore, chemotherapy-related HDL-C elevation was determined to be an independent prognostic indicator for superior DFS and OS.

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