Low Lipids Linked to Thyroid Cancer Recurrence

TOPLINE:
Lower preoperative levels of triglycerides and high-density lipoprotein (HDL) cholesterol are linked to higher recurrence rates in patients with papillary thyroid cancer, suggesting that preoperative serum lipids may help predict prognosis in papillary thyroid cancer.
METHODOLOGY:
Papillary thyroid cancer accounts for over 85% of all thyroid cancer cases. While disease-related death is relatively rare, the condition has a 28% recurrence rate, and an inverse association has been found between the risk for cancer and serum triglyceride levels.
Researchers conducted a retrospective cohort study to evaluate the prognostic utility of preoperative serum lipid levels in 3575 patients diagnosed with papillary thyroid cancer (mean age, 44.8 years; 73.5% women) between 2012 and 2016.
Patients were considered to have low levels of triglycerides and HDL if the serum concentrations were < 0.605 mmol/L and < 0.935 mmol/L, respectively.
The outcomes analyzed were disease-free survival, disease-specific survival, and overall survival.
The researchers also constructed a nomogram to test the predictive capacity of triglycerides and HDL on disease-free survival rates in 3575 patients, arbitrarily divided into the training cohort (n = 2503) and the validation cohort (n = 1072).
TAKEAWAY:
Over a median follow-up of 56.7 months, patients with lower vs higher levels of preoperative triglycerides and HDL had higher recurrence rates of papillary thyroid cancer after surgery (5.8% vs 2.7%; P = .002; and 4.4% vs 2.7%; P = .04, respectively).
Lower levels of triglycerides and HDL were independent predictors of postoperative disease recurrence (hazard ratios, 2.20 and 1.60, respectively).
The nomogram showed clinical predictive values of 0.80 and 0.82 for 3-year and 4-year disease-free survival, respectively, in the training cohort, with lymph node metastases being the most influential factor, followed by triglycerides, HDL, larger tumor size, and extrathyroidal extension.
Patients with low triglyceride levels had a lower 5-year disease-free survival rate (94.4%) than those with high triglyceride levels (97.2%; P < .001), with no statistical difference related to HDL levels.
IN PRACTICE:
“This study initially unveiled that preoperative serum concentrations of TAG [triglycerides] and HDL were independent indicators in predicting recurrence of PTCs [papillary thyroid cancer],” wrote the authors, who established a predictive nomogram model for clinicians that combines data on serum lipid profiles (triglycerides and HDL) with pathologic factors (tumor size, extrathyroidal extension, and lymph node metastasis).
SOURCE:
This study was led by Jimeng Yuan, Department of Surgical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China, and was published online in The Journal of Clinical Endocrinology & Metabolism.
LIMITATIONS:
This retrospective single-center study may have introduced selection bias. Only a single baseline measurement of preoperative serum lipids was used, which may not have fully captured the relationship between serum lipids and papillary thyroid cancer prognosis. The findings of this study require further validation. The potential molecular biological mechanisms involved in lipid metabolism in papillary thyroid cancer warrant systematic exploration.
DISCLOSURES:
This study was supported by the National Key Research and Development Program of China and the National Natural Science Foundation of China. The authors declared no conflicts of interests.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
 
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