title: Overall survival of cancer patients with serum lactate dehydrogenase greater than 1000 IU/L.
abstract: High level of serum lactate dehydrogenase (LDH) is a well-known poor prognostic factor in patients with malignancies. However, there was no data on overall survival (OS) in cancer patients with serum LDH level > 1000 IU/L, and the prognostic value of the changes in LDH over time for OS had not been reported. Clinical data of 311 cancer patients with metastatic disease with serum LDH >1000 IU/L (four times upper limit of normal) admitted consecutively to a single center were reviewed in this retrospective study. LDH level ranged from 1002 to 8235 U/L with a mean of 1689 U/L. The median OS was 1.7 months (95 % CI: 1.4-2.0). About half of patients (n = 163, 52 %) died within 2 months with the median OS of 0.5 months (95 % CI: 0.3-0.7). Only 173 patients were indicated for salvage treatment. Fifty-one patients' serum LDH level decreased to normal at 2 months following chemotherapy; OS was significantly longer in these patients (22.6 months, 95 % CI: 10.9-34.3, p < 0.001) compared to those with persistently abnormal serum LDH at 2 months (4.0 months, 95 % CI: 3.4-4.6). The independent factors that increased the death risk were ECOG performance status 3-4 (HR: 2.05, 95 % CI: 1.42-2.97, p < 0.001), supportive care only (HR: 2.91, 95 % CI: 2.06-4.10, p < 0.001), and persistently abnormal serum LDH at 2 months (HR: 2.72, 95 % CI: 1.67-4.42, p < 0.001). In conclusion, serum LDH level > 1000 IU/L predicted a terminal stage in metastatic cancer patients. OS was significantly prolonged in patients indicated for effective palliative treatment and LDH level decreased to normal at 2 months.
authors: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, China.
authors: Rujiao
authors: R
authors: Liu
authors: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, China.
authors: Jun
authors: J
authors: Cao
authors: Department of Clinical Laboratory, Fudan University Shanghai Cancer Center, Shanghai, China.|Shanghai Medical College, Fudan University, Shanghai, 200032, China.
authors: Xiang
authors: X
authors: Gao
authors: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, China.
authors: Jian
authors: J
authors: Zhang
authors: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, China.
authors: Leiping
authors: L
authors: Wang
authors: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, China.
authors: Biyun
authors: B
authors: Wang
authors: Department of Clinical Laboratory, Fudan University Shanghai Cancer Center, Shanghai, China.|Shanghai Medical College, Fudan University, Shanghai, 200032, China.
authors: Lin
authors: L
authors: Guo
authors: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, China.
authors: Xichun
authors: X
authors: Hu
authors: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China. zhonghuawang95@hotmail.com.|Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, China. zhonghuawang95@hotmail.com.
authors: Zhonghua
authors: Z
authors: Wang
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008297:Male; D009367:Neoplasm Staging; D009369:Neoplasms / Q000097:blood / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D007770:L-Lactate Dehydrogenase
keywords: Lactate dehydrogenase; Metastatic cancer; Overall survival; Palliative care; Prognostic factor