title: Prognostic value of pretreatment serum lactate dehydrogenase level in patients with solid tumors: a systematic review and meta-analysis.
abstract: Although most studies have reported that high serum lactate dehydrogenase (LDH) levels are associated with poor prognosis in several malignancies, the consistency and magnitude of the impact of LDH are unclear. We conducted the first comprehensive meta-analysis of the prognostic relevance of LDH in solid tumors. Overall survival (OS) was the primary outcome; progression-free survival (PFS) and disease-free survival (DFS) were secondary outcomes. We identified a total of 68 eligible studies that included 31,857 patients. High LDH was associated with a HR for OS of 1.48 (95% CI = 1.43 to 1.53; P < 0.00001; I(2) = 93%), an effect observed in all disease subgroups, sites, stages and cutoff of LDH. HRs for PFS and DFS were 1.70 (95% CI = 1.44 to 2.01; P < 0.00001; I(2) = 13%) and 1.86(95% CI = 1.15 to 3.01; P = 0.01; I(2) = 88%), respectively. Analysis of LDH as a continuous variable showed poorer OS with increasing LDH (HR 2.11; 95% CI = 1.35 to 3.28). Sensitivity analyses showed there was no association between LDH cutoff and reported HR for OS. High LDH is associated with an adverse prognosis in many solid tumors and its additional prognostic and predictive value for clinical decision-making warrants further investigation.
authors.affiliation: 1] Department of Interventional Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China [2] Research Group of Evidence-based Clinical Oncology, Tianjin, China [3] Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
authors.forename: Jiao
authors.initials: J
authors.lastname: Zhang
authors.affiliation: 1] Department of Interventional Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China [2] Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
authors.forename: Yan-Hong
authors.initials: YH
authors.lastname: Yao
authors.affiliation: 1] Department of Interventional Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China [2] Research Group of Evidence-based Clinical Oncology, Tianjin, China [3] Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
authors.forename: Bao-Guo
authors.initials: BG
authors.lastname: Li
authors.affiliation: 1] Department of Interventional Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China [2] Department of Urologic Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Yang
authors.affiliation: 1] Department of Interventional Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China [2] Department of Laboratory Medicine, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
authors.forename: Peng-Yu
authors.initials: PY
authors.lastname: Zhang
authors.affiliation: 1] Department of Interventional Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China [2] Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
authors.forename: Hai-Tao
authors.initials: HT
authors.lastname: Wang
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D016208:Databases, Factual; D018572:Disease-Free Survival; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D009369:Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D016016:Proportional Hazards Models; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D007770:L-Lactate Dehydrogenase