The association between hypocholesterolemia and lung cancer risk has been confirmed in some studies. The purpose of the study was to determine whether preoperative hypocholesterolemia (below normal range) is a prognostic factor for survival after nonsmall cell lung cancer (NSCLC) resection. Two hundred and sixty-two consecutive cases of resected NSCLC with a followup period for more than 5 years were reviewed retrospectively. In our results, there were only 13/262 patients having hypocholesterolemia. A significant association was observed between preoperative hypocholesterolemia and patients' survival. However, we failed to find the prognostic significance of preoperative hypocholesterolemia by univariate analysis. No statistical differences were also found by the comparison between 5-year survivors and the others. Our data indicates a trend toward an association between preoperative hypocholesterolemia and poorer survival in NSCLC; however, it did not reach statistical significance. 1. Introduction It has been well accepted that hypercholesterolemia is a major risk factor for coronary heart disease. On the other hand, hypercholesterolemia has been associated with an increased risk of cancer mortality [1]. Some previous studies [2–5] observed that hypocholesterolemia was associated with a significantly increased risk of lung cancer. To our knowledge, there is only one previous study that investigated the relationship between preoperative total serum cholesterol (TSC) and length of survival after nonsmall cell lung cancer (NSCLC) resection [6]. They reported that preoperative TSC might be an important prognostic factor for overall survival after NSCLC resection using the median value for TSC as the cutoff for dividing patients into low and high TSC groups [6]. However, they did not show the number of patients with TSC below normal range (hypocholesterolemia). We believe that hypocholesterolemia group should be defined as patients with TSC below normal range, not median value. Therefore, in the present study, we investigated the prognostic significance of preoperative TSC, using the comparison between NSCLC patients with hypocholesterolemia and others. 2. Patients and Methods The present retrospective study was conducted from 2001 through 2006 and included 262 patients with NSCLC who had underwent complete resection, which consisted of either a lobectomy or a pneumonectomy, together with regional lymph node dissection. Patients who did not have a preoperative dosage of cholesterol and who had a followup period of less than 5 years were excluded. The
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