Serum lactate dehydrogenase is a possible predictor of platinum resistance in ovarian cancer
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ObjectiveThe need for tailoring ovarian cancer treatments to individual patients is increasing. This study aimed to evaluate theprognostic value of pretreatment laboratory test data for predicting the response and survival outcomes of platinumbasedchemotherapy in ovarian cancer. MethodsWe enrolled 270 patients with ovarian cancer diagnosed at the Kyoto Medical Center (n=120; group A) and KyotoUniversity (n=150; group B). Data on 9 blood parameters (neutrophil to lymphocyte ratio [NLR], platelet to lymphocyterate [PLR], C-reactive protein, lactate dehydrogenase [LDH], glucose, total cholesterol, high-density lipoprotein [HDL],low-density lipoprotein, and triglyceride levels), cancer pathology, cancer stage, cytoreduction outcomes, serumcancer antigen 125 levels, platinum-free interval (PFI), disease-free survival (DFS), and overall survival were assessedretrospectively. ResultsNLR, PLR, LDH, and HDL were significantly different in advanced stage patients (P<0.001, <0.001, 0.029, and <0.001,respectively). The Kaplan-Meier curves revealed that high LDH level (≥250 U/L) was associated with reduced PFI(P=0.037 and 0.012) and DFS (P=0.007 and 0.002) in groups A and B, respectively. High NLR (≥4) was associated withreduced DFS in both groups (P=0.036 and 0.005, respectively). LDH showed higher area under the curve (AUC) valuesin predicting platinum resistance with a PFI of less than 6 months and 12 months (AUC=0.606 and 0.646, respectively)than NLR. In the multivariate analysis, LDH remained significant (P=0.019) after adjusting for the 9 blood parameters. ConclusionSerum LDH level may possibly predict platinum resistance and prognosis in ovarian cancer and may be useful whendeveloping precision medicine for individual patients.
Abstract
ObjectiveThe need for tailoring ovarian cancer treatments to individual patients is increasing. This study aimed to evaluate theprognostic value of pretreatment laboratory test data for predicting the response and survival outcomes of platinumbasedchemotherapy in ovarian cancer. MethodsWe enrolled 270 patients with ovarian cancer diagnosed at the Kyoto Medical Center (n=120; group A) and KyotoUniversity (n=150; group B). Data on 9 blood parameters (neutrophil to lymphocyte ratio [NLR], platelet to lymphocyterate [PLR], C-reactive protein, lactate dehydrogenase [LDH], glucose, total cholesterol, high-density lipoprotein [HDL],low-density lipoprotein, and triglyceride levels), cancer pathology, cancer stage, cytoreduction outcomes, serumcancer antigen 125 levels, platinum-free interval (PFI), disease-free survival (DFS), and overall survival were assessedretrospectively. ResultsNLR, PLR, LDH, and HDL were significantly different in advanced stage patients (P<0.001, <0.001, 0.029, and <0.001,respectively). The Kaplan-Meier curves revealed that high LDH level (≥250 U/L) was associated with reduced PFI(P=0.037 and 0.012) and DFS (P=0.007 and 0.002) in groups A and B, respectively. High NLR (≥4) was associated withreduced DFS in both groups (P=0.036 and 0.005, respectively). LDH showed higher area under the curve (AUC) valuesin predicting platinum resistance with a PFI of less than 6 months and 12 months (AUC=0.606 and 0.646, respectively)than NLR. In the multivariate analysis, LDH remained significant (P=0.019) after adjusting for the 9 blood parameters. ConclusionSerum LDH level may possibly predict platinum resistance and prognosis in ovarian cancer and may be useful whendeveloping precision medicine for individual patients.
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