title: Serum lactate dehydrogenase and survival following cancer diagnosis.
abstract: BACKGROUND
  There is evidence that high level of serum lactate dehydrogenase (LDH) is associated with poorer overall survival in several malignancies, but its link to cancer-specific survival is unclear.
  
  
  METHODS
  A total of 7895 individuals diagnosed with cancer between 1986 and 1999 were selected for this study. Multivariable Cox proportional hazards regression was used to assess overall and cancer-specific death by the z-score and clinical categories of serum LDH prospectively collected within 3 years before diagnosis. Site-specific analysis was performed for major cancers. Analysis was repeated by different lag times between LDH measurements and diagnosis.
  
  
  RESULTS
  At the end of follow-up, 5799 participants were deceased. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall and cancer-specific death in the multivariable model were 1.43 (1.31-1.56) and 1.46 (1.32-1.61), respectively, for high compared with low prediagnostic LDH. Site-specific analysis showed high LDH to correlate with an increased risk of death from prostate, pulmonary, colorectal, gastro-oesophageal, gynaecological and haematological cancers. Serum LDH assessed within intervals closer to diagnosis was more strongly associated with overall and cancer-specific death.
  
  
  CONCLUSIONS
  Our findings demonstrated an inverse association of baseline serum LDH with cancer-specific survival, corroborating its role in cancer progression.
authors.affiliation: Division of Cancer Studies, Cancer Epidemiology Group, King's College London, Research Oncology, 3rd Floor, Bermondsey Wing, Guy's Hospital, London SE1 9RT, UK.
authors.forename: Wahyu
authors.initials: W
authors.lastname: Wulaningsih
authors.affiliation: Division of Cancer Studies, Cancer Epidemiology Group, King's College London, Research Oncology, 3rd Floor, Bermondsey Wing, Guy's Hospital, London SE1 9RT, UK.|Department of Surgical Sciences, Uppsala University Hospital, Uppsala 751 85, Sweden.|Regional Cancer Centre, Uppsala 751 85, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Holmberg
authors.affiliation: Division of Cancer Studies, Cancer Epidemiology Group, King's College London, Research Oncology, 3rd Floor, Bermondsey Wing, Guy's Hospital, London SE1 9RT, UK.|Regional Cancer Centre, Uppsala 751 85, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Garmo
authors.affiliation: Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden.
authors.forename: Håkan
authors.initials: H
authors.lastname: Malmstrom
authors.affiliation: Regional Cancer Centre, Uppsala 751 85, Sweden.|Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 171 77, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Lambe
authors.affiliation: Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden.|AstraZeneca R&D, Mölndal 431 50, Sweden.
authors.forename: Niklas
authors.initials: N
authors.lastname: Hammar
authors.affiliation: Department of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden.
authors.forename: Göran
authors.initials: G
authors.lastname: Walldius
authors.affiliation: Department of Medicine, Clinical Epidemiological Unit, Karolinska Institutet and CALAB Research, Stockholm 171 77, Sweden.
authors.forename: Ingmar
authors.initials: I
authors.lastname: Jungner
authors.affiliation: Richard Dimbleby Department of Cancer Research, Randall Division and Division of Cancer Studies, King's College London, London SE1 1UL, UK.
authors.forename: Tony
authors.initials: T
authors.lastname: Ng
authors.affiliation: Division of Cancer Studies, Cancer Epidemiology Group, King's College London, Research Oncology, 3rd Floor, Bermondsey Wing, Guy's Hospital, London SE1 9RT, UK.|Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden.
authors.forename: Mieke
authors.initials: M
authors.lastname: Van Hemelrijck
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*
chemical_list: D007770:L-Lactate Dehydrogenase