Varying postresection lactate dehydrogenase with overall survival of early stage pancreatic cancer patients: A retrospective study.
Several previously published studies revealed a hazardous role of pretreatment lactate dehydrogenase (LDH) in survival of advanced or metastatic pancreatic cancer (PC) patients. Nevertheless, in early stage PC patients who are eligible for curative resection, the prognostic role of postresection LDH has never been discussed. In this study, we aimed to explore the prognostic significance of varying postresection LDH among early stage PC patients. In total, 80 PC patients who received curative resection were retrospectively selected from a population-based electronic inpatients database which originated from Shanghai, China. A dynamic survival analysis method, counting process approach in combination with the multiple failure-time Cox model, was applied to evaluate the association between postresection LDH and OS. The multiple failure-time Cox model found that age, resection modality, and postresection LDH were significantly associated with OS: an elevated LDH (defined as > 250 U/L) was related to 2.93 (95% CI: 1.26-6.79) folds of death hazard. Further analysis disclosed an identifiable dose-response association between LDH and OS: compared with LDH≤155 U/L, the HRs for 155 U/L < LDH < 196 U/L, and LDH≥196 U/L were 2.07 (95% CI: 0.88-4.88) and 3.15 (95% CI: 1.30-7.59), respectively. Our study results suggest that postresection LDH is a prominent prognostic factor in this group of early stage PC patients. Maintaining normally ranged LDH after resection might bring about survival benefit in early stage PC patients.
School of Public Health, Kunming Medical University, Kunming, Yunnan Department of Biostatistics, School of Public Health, Fudan University Information Center, Shanghai Municipal Commission of Health and Family Planning Key Lab of Health Technology Assessment, Ministry of Health (Fudan University), Shanghai, China.
Yuanyuan
Y
Xiao
Zhihui
Z
Xie
Zhenyi
Z
Shao
Wen
W
Chen
Hua
H
Xie
Guoyou
G
Qin
Naiqing
N
Zhao
D000367:Age Factors; D014408:Biomarkers, Tumor / Q000378:metabolism; D017024:Chemotherapy, Adjuvant; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000201:enzymology* / Q000401:mortality / Q000601:surgery*; D011184:Postoperative Period; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis; D017211:Treatment Failure
D014408:Biomarkers, Tumor; D007770:L-Lactate Dehydrogenase