10.6084/m9.figshare.4557664.v1
Fausto Petrelli
Fausto
Petrelli
Mary Cabiddu
Mary
Cabiddu
Andrea Coinu
Andrea
Coinu
Karen Borgonovo
Karen
Borgonovo
Mara Ghilardi
Mara
Ghilardi
Veronica Lonati
Veronica
Lonati
Sandro Barni
Sandro
Barni
Prognostic role of lactate dehydrogenase in solid tumors: A systematic review and meta-analysis of 76 studies
Taylor & Francis Group
2017
serum level
22 882 patients
disease-free survival
Seventy-six studies
hematological malignancies
lactate production
OS
cancer cells
serum LDH
random-effect modeling
Pooled HRs
prognostic value
73 studies
Prognostic role
Lactate dehydrogenase
CSS
cancer-specific survival
prognostic effect
tumor
cell carcinomas
lactate dehydrogenase
form lactate
CI
DFS
metastatic carcinomas
outcome
76 studies Background
serum LDH level
LDH levels
lung cancers
prognostic biomarker
energy source
hazard ratio
PFS
2017-01-17 09:36:34
Journal contribution
https://tandf.figshare.com/articles/journal_contribution/Prognostic_role_of_lactate_dehydrogenase_in_solid_tumors_A_systematic_review_and_meta-analysis_of_76_studies/4557664
<p><b>Background.</b> In cancer cells, metabolism is shifted to aerobic glycolysis with lactate production coupled with a higher uptake of glucose as the main energy source. Lactate dehydrogenase (LDH) catalyzes the reduction of pyruvate to form lactate, and serum level is often raised in aggressive cancer and hematological malignancies. We have assessed the prognostic value of LDH in solid tumors.</p> <p><b>Material and methods.</b> A systematic review of electronic databases was conducted to identify publications exploring the association of LDH with clinical outcome in solid tumors. Overall survival (OS) was the primary outcome, and cancer-specific survival (CSS), progression-free survival (PFS), and disease-free survival (DFS) were secondary outcomes. Data from studies reporting a hazard ratio (HR) and 95% confidence interval (CI) were pooled in a meta-analysis. Pooled HRs were computed and weighted using generic inverse-variance and random-effect modeling. All statistical tests were two-sided.</p> <p><b>Results.</b> Seventy-six studies comprising 22 882 patients, mainly with advanced disease, were included in the analysis. Median cut-off of serum LDH was 245 U/L. Overall, higher LDH levels were associated with a HR for OS of 1.7 (95% CI 1.62–1.79; p < 0.00001) in 73 studies. The prognostic effect was highest in renal cell, melanoma, gastric, prostate, nasopharyngeal and lung cancers (all p < 0.00001). HRs for PFS was 1.75 (all p < 0.0001).</p> <p><b>Conclusions.</b> A high serum LDH level is associated with a poor survival in solid tumors, in particular melanoma, prostate and renal cell carcinomas, and can be used as a useful and inexpensive prognostic biomarker in metastatic carcinomas.</p>