title: Pre-treatment serum lactate dehydrogenase level is an important prognostic factor in high-grade extremity osteosarcoma.
abstract: BACKGROUND
  Treatment of high-grade osteosarcoma remains a challenge. The prognostic significance of the pre-treatment serum lactate dehydrogenase (LDH) level is currently controversial.
  
  
  METHODS
  We reviewed records from all patients diagnosed with conventional high-grade osteosarcoma at our institution over a 25-year period and analysed the prognostic significance of LDH in high-grade localised extremity osteosarcomas treated with chemotherapy.
  
  
  RESULTS
  Between June 1977 and March 2003, 66 patients for whom follow-up was available were diagnosed with localised high-grade extremity osteosarcoma and treated with chemotherapy. The median age was 15 years, with only 3% older than 40 years, and the median follow-up was 100 months. The median progression-free survival (PFS) was 67 months and the median overall survival (OS) was 113 months. The absence of a response to chemotherapy was correlated with a trend toward lower PFS and OS. High serum pre-treatment LDH level was associated in multivariate analyses with a poorer prognosis for both PFS (HR=8.623, 95%CI: 1.71-43.37; p=0.009) and for OS (HR=9.38; 95%CI: 1.73-50.74; p=0.009).
  
  
  CONCLUSIONS
  In this series, the pre-treatment serum LDH level had an independent prognostic value for both PFS and OS in patients with high-grade localised extremity osteosarcoma. This measurement should be included in a large prospective prognostic series.
authors: Haematology and Oncology Department, Hospital General Universitario Morales Meseguer, Murcia, Spain.
authors: Enrique
authors: E
authors: González-Billalabeitia
authors: Ricardo
authors: R
authors: Hitt
authors: Jesús
authors: J
authors: Fernández
authors: Esther
authors: E
authors: Conde
authors: Francisco
authors: F
authors: Martínez-Tello
authors: Rafael
authors: R
authors: Enríquez de Salamanca
authors: Hernán
authors: H
authors: Cortés-Funes
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012516:Osteosarcoma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D011379:Prognosis
chemical_list: D007770:L-Lactate Dehydrogenase