The prognostic value of preoperative serum lactate dehydrogenase levels in patients underwent curative‐intent hepatectomy for colorectal liver metastases: A two‐center cohort study
Abstract Background The prognostic value of lactate dehydrogenase (LDH) in colorectal cancer patients has remained inconsistent between nonmetastatic and metastatic settings. So far, very few studies have included LDH in the prognostic analysis of curative‐intent surgery for colorectal liver metasta...
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2021
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oai:doaj.org-article:379bb3dd7c62469a931ce8bb0e4b01982021-11-22T09:08:47ZThe prognostic value of preoperative serum lactate dehydrogenase levels in patients underwent curative‐intent hepatectomy for colorectal liver metastases: A two‐center cohort study2045-763410.1002/cam4.4315https://doaj.org/article/379bb3dd7c62469a931ce8bb0e4b01982021-11-01T00:00:00Zhttps://doi.org/10.1002/cam4.4315https://doaj.org/toc/2045-7634Abstract Background The prognostic value of lactate dehydrogenase (LDH) in colorectal cancer patients has remained inconsistent between nonmetastatic and metastatic settings. So far, very few studies have included LDH in the prognostic analysis of curative‐intent surgery for colorectal liver metastases (CRLM). Patients and Methods Five hundred and eighty consecutive metastatic colorectal cancer patients who underwent curative‐intent CRLM resection from Sun Yat‐sen University Cancer Center (434 patients) and Sun Yat‐sen University Sixth Affiliated Hospital (146 patients) in 2000–2019 were retrospectively collected. Overall survival (OS) was the primary end point. Cox regression model was performed to identify the prognostic values of preoperative serum LDH levels and other clinicopathology variables. A modification of the established Fong CRS scoring system comprising LDH was developed within this Chinese population. Results At the median follow‐up time of 60.5 months, median OS was 59.5 months in the pooled cohort. In the multivariate analysis, preoperative LDH >upper limit of normal (250 U/L) was the strongest independent prognostic factor for OS (HR 1.73, 95% confidence interval [CI], 1.22–2.44; p < 0.001). Patients with elevated LDH levels showed impaired OS than patients with normal LDH levels (27.6 months vs. 68.8 months). Five‐year survival rates were 53.7% and 22.5% in the LDH‐normal group and LDH‐high group, respectively. Similar results were also confirmed in each cohort. In the subgroup analysis, LDH could distinguish the survival regardless of most established prognostic factors (number and size of CRLM, surgical margin, extrahepatic metastases, CEA, and CA19‐9 levels, etc.). Integrating LDH into the Fong score contributed to an improvement in the predictive value. Conclusion Our study implicates serum LDH as a reliable and independent laboratory biomarker to predict the clinical outcome of curative‐intent surgery for CRLM. Composite of LDH and Fong score is a potential stratification tool for CRLM resection. Prospective, international studies are needed to validate these results across diverse populations.Long BaiZe‐Yu LinYun‐Xin LuQin ChenHan ZhouQi MengChun‐Ping LinWan‐Lan HuangYun‐Le WanZhi‐Zhong PanDe‐Shen WangWileyarticlecirculating biomarkercolorectal liver metastases (CRLM)hepatectomylactate dehydrogenase (LDH)Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancer Medicine, Vol 10, Iss 22, Pp 8005-8019 (2021) |
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| topic |
circulating biomarker colorectal liver metastases (CRLM) hepatectomy lactate dehydrogenase (LDH) Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 |
| spellingShingle |
circulating biomarker colorectal liver metastases (CRLM) hepatectomy lactate dehydrogenase (LDH) Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Long Bai Ze‐Yu Lin Yun‐Xin Lu Qin Chen Han Zhou Qi Meng Chun‐Ping Lin Wan‐Lan Huang Yun‐Le Wan Zhi‐Zhong Pan De‐Shen Wang The prognostic value of preoperative serum lactate dehydrogenase levels in patients underwent curative‐intent hepatectomy for colorectal liver metastases: A two‐center cohort study |
| description |
Abstract Background The prognostic value of lactate dehydrogenase (LDH) in colorectal cancer patients has remained inconsistent between nonmetastatic and metastatic settings. So far, very few studies have included LDH in the prognostic analysis of curative‐intent surgery for colorectal liver metastases (CRLM). Patients and Methods Five hundred and eighty consecutive metastatic colorectal cancer patients who underwent curative‐intent CRLM resection from Sun Yat‐sen University Cancer Center (434 patients) and Sun Yat‐sen University Sixth Affiliated Hospital (146 patients) in 2000–2019 were retrospectively collected. Overall survival (OS) was the primary end point. Cox regression model was performed to identify the prognostic values of preoperative serum LDH levels and other clinicopathology variables. A modification of the established Fong CRS scoring system comprising LDH was developed within this Chinese population. Results At the median follow‐up time of 60.5 months, median OS was 59.5 months in the pooled cohort. In the multivariate analysis, preoperative LDH >upper limit of normal (250 U/L) was the strongest independent prognostic factor for OS (HR 1.73, 95% confidence interval [CI], 1.22–2.44; p < 0.001). Patients with elevated LDH levels showed impaired OS than patients with normal LDH levels (27.6 months vs. 68.8 months). Five‐year survival rates were 53.7% and 22.5% in the LDH‐normal group and LDH‐high group, respectively. Similar results were also confirmed in each cohort. In the subgroup analysis, LDH could distinguish the survival regardless of most established prognostic factors (number and size of CRLM, surgical margin, extrahepatic metastases, CEA, and CA19‐9 levels, etc.). Integrating LDH into the Fong score contributed to an improvement in the predictive value. Conclusion Our study implicates serum LDH as a reliable and independent laboratory biomarker to predict the clinical outcome of curative‐intent surgery for CRLM. Composite of LDH and Fong score is a potential stratification tool for CRLM resection. Prospective, international studies are needed to validate these results across diverse populations. |
| format |
article |
| author |
Long Bai Ze‐Yu Lin Yun‐Xin Lu Qin Chen Han Zhou Qi Meng Chun‐Ping Lin Wan‐Lan Huang Yun‐Le Wan Zhi‐Zhong Pan De‐Shen Wang |
| author_facet |
Long Bai Ze‐Yu Lin Yun‐Xin Lu Qin Chen Han Zhou Qi Meng Chun‐Ping Lin Wan‐Lan Huang Yun‐Le Wan Zhi‐Zhong Pan De‐Shen Wang |
| author_sort |
Long Bai |
| title |
The prognostic value of preoperative serum lactate dehydrogenase levels in patients underwent curative‐intent hepatectomy for colorectal liver metastases: A two‐center cohort study |
| title_short |
The prognostic value of preoperative serum lactate dehydrogenase levels in patients underwent curative‐intent hepatectomy for colorectal liver metastases: A two‐center cohort study |
| title_full |
The prognostic value of preoperative serum lactate dehydrogenase levels in patients underwent curative‐intent hepatectomy for colorectal liver metastases: A two‐center cohort study |
| title_fullStr |
The prognostic value of preoperative serum lactate dehydrogenase levels in patients underwent curative‐intent hepatectomy for colorectal liver metastases: A two‐center cohort study |
| title_full_unstemmed |
The prognostic value of preoperative serum lactate dehydrogenase levels in patients underwent curative‐intent hepatectomy for colorectal liver metastases: A two‐center cohort study |
| title_sort |
prognostic value of preoperative serum lactate dehydrogenase levels in patients underwent curative‐intent hepatectomy for colorectal liver metastases: a two‐center cohort study |
| publisher |
Wiley |
| publishDate |
2021 |
| url |
https://doaj.org/article/379bb3dd7c62469a931ce8bb0e4b0198 |
| work_keys_str_mv |
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