Low-Density Lipoprotein (LDL) is Associated with Earlier Progression in Synchronous Metastatic Colorectal Cancer Treated without Curative Intent.
Level 3 - non-randomized controlled study
Non-randomized observational cohort study.
PubMed 39907838 · doi:10.1007/s12029-025-01166-3
What was done
Patients with newly diagnosed synchronous metastatic colorectal cancer were evaluated in an observational cohort study. Participants were grouped by serum low-density lipoprotein (LDL) cholesterol at diagnosis into normal-LDL (<= 130 mg/dL) and high-LDL (> 130 mg/dL) groups. Baseline clinicopathological characteristics, progression-free survival (PFS), and overall survival (OS) were analyzed.
What was found
Of 90 patients included, 40 (44.4%) had normal LDL and 50 (56.6% reported) had high LDL. Colonic localization was higher in the high-LDL group (90% vs. 67.5%, p = 0.009). The high-LDL group underwent more local treatments: metastasectomy (26% vs. 2.5%, p = 0.002) and embolization-ablation (38% vs. 17.5%, p = 0.033). In the overall cohort, PFS (10.03 months [95% CI: 6.97-14.77] vs. 9.63 months [95% CI: 7.93-14.00], p = 0.872) and OS (20.87 months [95% CI: 14.87-36.47] vs. 17.63 months [95% CI: 14.30-43.03], p = 0.925) did not differ significantly. Among patients treated without curative intent, high LDL was associated with significantly worse PFS (4.97 months [95% CI: 3.00-7.73] vs. 8.43 months [95% CI: 6.10-9.90], p = 0.048).
Why it matters
Elevated baseline serum LDL may indicate specific tumor localization and may serve as an adverse prognostic indicator for progression-free survival in metastatic colorectal cancer managed without curative intent.
Limits
Small sample size (n = 90), non-randomized single-center design, and survival differences emerged only in a non-curative subgroup analysis. Confounding variables such as statin use or baseline metabolic syndrome features were not reported in the abstract.