The prognostic value of preoperative serum lactate dehydrogenase levels in patients with resectable non-metastatic rectal adenocarcinoma

The prognostic value of preoperative serum lactate dehydrogenase levels in patients with resectable non-metastatic rectal adenocarcinoma

 

1.Halime Hanım Pençe (halime.pence@hotmail.com)

University of Health Sciences, Department of Biochemistry, Istanbul, Turkey

2.Aziz Serkan Senger(serkansenger@yahoo.com)

SBÜ.Kartal Koşuyolu High Speciality and Training Hospital Gastroenterological Surgery Department, Kartal, Istanbul

3.Ebubekir Gündeş (ebubekir82@hotmail.com)

SBÜ.Gazi Yaşargil Education and Training Hospital, Gastroenterological Surgery, Diyarbakır, Turkey

4.Hüseyin Çiyiltepe (drciyiltepe@hotmail.com)

SBÜ.Fatih Sultan Mehmet Education and Training Hospital, Gastroenterological Surgery, Istanbul, Turkey

5.Hani Alsaadoni (hani_alsadoni@hotmail.com)

University of Health Sciences, Department of Physiology, Istanbul, Turkey

6.Ulaş Aday (ulasaday@gmail.com)

SBÜ. Elazığ Education and Training Hospital, Gastroenterological Surgery, Elazığ, Turkey

7.Mustafa Duman (drmustafaduman@hotmail.com)

SBÜ.Kartal Koşuyolu High Speciality and Training Hospital Gastroenterological Surgery Department, Kartal, Istanbul

8.Erdal Polat (erdal66@yahoo.com)

SBÜ. Kartal Koşuyolu High Speciality and Training Hospital Gastroenterological Surgery Department, Kartal, Istanbul

 

Abstract

 

Background: The prognostic value of lactate dehydrogenase has been investigated for years, particularly in patients with metastatic colorectal cancer, although the results of such studies proved to be controversial and the cases were heterogeneous. Nevertheless, there is a limited number of studies on its prognostic value in resectable non-metastatic rectal cancer cases.

Material and Methods: We reviewed serum lactate dehydrogenase (SLDH) and other preoperative data of 80 patients with rectal cancer who had undergone surgery between January 2010 and September 2017 in our clinic. The patients were divided into two groups as per their SLDH levels (normal SLDH and high SLDH). The cut-off point was set according to the upper limit of normal SLDH levels. The Chi-square test was used to analyze the relationships between LDH and clinical features. Independent risk factors for overall survival (OS) were ascertained by logistic regression analysis.

Results: While 45 (56.25%) of the patients included in the study were male, 35 (43.75%) were female and their mean age was 64.43±11.40 years. Maximum tumor diameter (p:0.034), lymphovascular invasion (p: 0.004), lymph node involvement (N) (p:0.001), and depth of infiltration (T) (p: 0.03) were found to be significantly higher in the HSLDH group. The results of the univariate analysis for overall survival revealed that NLR (≥4), PLR (≥160), HSLDH (>245 U/l), maximum tumor diameter (≥4 cm), lymphovascular invasion, perineural invasion, LNR, N (+) and T (III- IV) had statistically significant relationships with the dependent variable. Yet, it was determined that these variables that were found to be significant in the univariate analysis were not so in the multivariant analysis. Moreover, results of the Kaplan-Meier analysis also unveiled that the HSLDH (> 245 U / L) levels were significantly associated with poor OS (p: 0.002).

Conclusion: HSLDH levels suggest lymphovascular invasion, advanced N, T stages and presence of large tumor masses although the results of our study did not reveal HSLDH levels as an independent poor prognostic factor for overall survival in resectable non-metastatic rectal cancer cases.

Key words: Rectal cancer, lactate dehydrogenase, Warbu=rg effect

 

 

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