title: Serum lactate dehydrogenase levels at presentation in stage IV non-small cell lung cancer: predictive value of metastases and relation to survival outcomes.
abstract: This study aimed to evaluate the clinical correlations between serum lactate dehydrogenase (LDH) levels and tumor characteristics and to investigate the prognostic impact of serum LDH levels in advanced non-small cell lung cancer (NSCLC). A total of 394 patients were included in the present study between June 2007 and January 2013. All eligible patients had serum LDH levels available before treatment, and whole-body metastatic extent was measured using whole-body metastatic scores, as determined by 18(F)-fludeoxyglucose positron emission tomography scans from 1 to 7 as the sum of each metastatic region. The diagnostic cutoff value for an abnormal serum LDH level was 450 IU/L. The median serum LDH level was 477 IU/L (range, 113-2850), and 224 (56.9 %) patients had abnormal serum LDH levels. The serum LDH levels showed no significant associations with age, gender, histology, tumor differentiation, and smoking history. However, the proportion of patients with abnormal serum LDH levels was statistically significantly higher in the high total metastatic score group (scores 3-7) than in the low total metastatic score group (scores 1-2) (65.3 vs 50.4 %, p = 0.001). In a multivariate survival analysis, age (p = 0.001), gender (p = 0.001), histology (p = 0.003), tumor differentiation (p = 0.001), Eastern Cooperative Oncology Group (ECOG) performance status (p = 0.001), LDH levels (p = 0.046), and treatment factors (p = 0.001) proved to be independent prognostic factors for survival outcomes. The results of this study suggest that the serum LDH levels at presentation may be significantly correlated with whole-body tumor extent and might independently but modestly prognosticate OS in stage IV NSCLC.
authors.affiliation: Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, School of Medicine, Ewha Womans University, Seoul, South Korea.
authors.forename: Kyung Ran
authors.initials: KR
authors.lastname: Park
authors.affiliation: Division of Pulmonology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Seung Joon
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Mi Joo
authors.initials: MJ
authors.lastname: Chung
authors.affiliation: Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Yun Hee
authors.initials: YH
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Chang
authors.affiliation: Department of Medical Oncology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Jin Hyoung
authors.initials: JH
authors.lastname: Kang
authors.affiliation: Department of Medical Oncology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Sook Hee
authors.initials: SH
authors.lastname: Hong
authors.affiliation: Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Myung Sin
authors.initials: MS
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, South Korea. yeonkim7@catholic.ac.kr.
authors.forename: Yeon Sil
authors.initials: YS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008175:Lung Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis
chemical_list: D015415:Biomarkers; D007770:L-Lactate Dehydrogenase
keywords: Lactate dehydrogenase; Metastases; Non-small cell lung cancer; Prognosis