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Prognostic value of lactate dehydrogenase to albumin ratio (LAR) in patients with resectable esophageal squamous cell carcinoma

Authors Feng JF, Wang L, Yang X, Jiang YH

Received 20 March 2019

Accepted for publication 5 July 2019

Published 31 July 2019 Volume 2019:11 Pages 7243—7251

DOI https://doi.org/10.2147/CMAR.S208320

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Beicheng Sun


Ji-Feng Feng,1,2 Liang Wang,1 Xun Yang,1 You-Hua Jiang1,2

1Department of Thoracic Surgery, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou 310022, People’s Republic of China; 2Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Hangzhou, Zhejiang Province 310022, People’s Republic of China

Background: We firstly identified a combination of lactate dehydrogenase (LDH) along with albumin (ALB), which was defined as LAR (LDH/ALB ratio). The purpose of our study here was initially to explore the prognostic role of LAR in patients with esophageal squamous cell carcinoma (ESCC) undergoing esophagectomy.
Patients and methods: A retrospective study was conducted including 346 resectable ESCC patients. Patients who received curative surgery without any neoadjuvant therapy were included in the current study. The X-tile program was performed to calculate the optimal cut-off values for LDH, ALB and LAR. The Kaplan-Meier methods, Cox regression univariate and multivariate analyses were utilized to analyze the prognostic factors for cancer-specific survival (CSS).
Results: There were 76 (22.0%) women and 270 (78.0%) men in all 346 patients. The mean value for serum LDH, ALB and LAR were 180±62 U/L (range 28–473 U/L), 40.3±5.3 g/L (range 26.6–52.4 g/L) and 4.6±1.8 (range 0.64–14.97), respectively. According to the X-tile program, the optimum cut-off points were 220 (U/L), 40.5 (g/L), and 5.5 for LDH, ALB, and LAR, respectively. The 5-year CSS was 31.8%. Patients with a high level of LAR (>5.5) were associated with poor CSS (13.3% vs 38.3%, P<0.001). Multivariate analyses revealed that LAR was an independent predictor in resectable ESCC patients (P=0.038).
Conclusion: Our retrospective observations indicate that LAR is a useful potential prognostic biomarker in resectable ESCC patients who received curative surgery without any neoadjuvant therapy with the optimal cut-off value of 5.5.

Keywords: esophageal squamous cell carcinoma, lactate dehydrogenase, albumin, prognosis

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