title: Prognostic significance of serum lactate dehydrogenase level in osteosarcoma: a meta-analysis.
abstract: BACKGROUND
  A number of studies have investigated the role of serum lactate dehydrogenase (LDH) level in patients with osteosarcoma but have yielded inconsistent and inconclusive results. Thus, we conducted a meta-analysis to assess its prognostic value more precisely.
  
  
  METHODS
  Systematic computerized searches of PubMed, Embase and Web of Science databases were performed. The pooled hazard ratio (HR) with 95 % confidence intervals (95 % CI) of overall survival was used to assess the prognostic role of serum LDH level.
  
  
  RESULTS
  Ten studies published between 1997 and 2013 with a total of 943 osteosarcoma patients were included. Overall, the pooled HR for all ten eligible studies evaluating high LDH level on overall survival was 1.92(95 % CI 1.53-2.40). Sensitivity analysis suggested that the pooled HR was stable and omitting a single study did not change the significance of the pooled HR. Funnel plots and Egger's tests revealed there was some possibility of publication bias risk in the meta-analysis.
  
  
  CONCLUSIONS
  This meta-analysis shows that high serum LDH level is obviously associated with lower overall survival rate in patients with osteosarcoma, and it is an effective biomarker of prognosis.
authors.affiliation: Department of Orthopaedics, Shanghai First People's Hospital, Nanjing Medical University, Shanghai, 200072, China, chenjianpumch@163.com.
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
authors.forename: Meng-xiong
authors.initials: MX
authors.lastname: Sun
authors.forename: Ying-qi
authors.initials: YQ
authors.lastname: Hua
authors.forename: Zheng-dong
authors.initials: ZD
authors.lastname: Cai
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D001859:Bone Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D045022:Lactate Dehydrogenases / Q000097:blood*; D012516:Osteosarcoma / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor; D045022:Lactate Dehydrogenases