Abstract
Background: To investigate the potential prognostic role of serum lactate dehydrogenase (LDH) in patients with urothelial carcinoma (UC) using the method of systematic review and meta-analysis.Materials and Methods: We searched PubMed, Embase, Cochrane Library, and Web of Science for eligible studies up to February 2020. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were used to estimate the relationship.Results: A total of 14 studies including 4,009 patients with UC were incorporated. The results showed that a high pretreatment serum LDH was associated with an inferior overall survival (OS, HR 1.61, 95% CI 1.39–1.87, p < 0.001), cancer-specific survival (CSS, HR 1.41, 95% CI 1.05–1.90, p = 0.022), and disease-free survival (DFS, HR 1.64, 95% CI 1.04–2.59, p = 0.034) in UC. Subgroup analyses identified that a high pretreatment serum LDH was associated with a poor OS (HR 1.97, 95% CI 1.02–3.81, p = 0.042) and DFS (HR 1.64, 95% CI 1.04–2.59, p = 0.034) in upper tract urothelial carcinoma, a short OS (HR 1.71, 95% CI 1.37–2.15, p < 0.001) in urothelial carcinoma of bladder.Conclusion: Our findings indicated that a high level of pretreatment serum LDH was associated with inferior OS, CSS, and DFS in patients with UC. This biomarker can be an important factor incorporated into the prognostic models for UC.
Highlights
Urothelial carcinoma (UC), mainly consisting of upper tract urothelial carcinoma (UTUC) and urothelial carcinoma of the bladder (UCB), is, respectively estimated to have 85,000 new incidences and 18,000 related mortality in the United States in 2018
After merging hazard ratios (HRs) and 95% confidence interval (CI), we identified that a high pretreatment serum lactate dehydrogenase (LDH) was associated with an inferior overall survival (HR 1.61, 95% CI 1.39–1.87, p < 0.001), cancer-specific survival (HR 1.41, 95% CI 1.05–1.90, p = 0.022), and disease-free survival (HR 1.64, 95% CI 1.04–2.59, p = 0.034) in patients with urothelial carcinoma (Figure 2)
After merging HRs and 95% CIs, we identified that a high pretreatment serum LDH was associated with a poor overall survival (HR 1.97, 95% CI 1.02–3.81, p = 0.042) and disease-free survival (HR 1.64, 95% CI 1.04–2.59, p = 0.034) in patients with UTUC (Figure 3A)
Summary
Urothelial carcinoma (UC), mainly consisting of upper tract urothelial carcinoma (UTUC) and urothelial carcinoma of the bladder (UCB), is, respectively estimated to have 85,000 new incidences and 18,000 related mortality in the United States in 2018. These made UC become the 4th and 12th most common malignance for males and females (1). For patients with advanced UC, median overall survival was only 3 to 6 months without therapy, and prolonged to 13–16 months when receiving systematic chemotherapy (3). To investigate the potential prognostic role of serum lactate dehydrogenase (LDH) in patients with urothelial carcinoma (UC) using the method of systematic review and meta-analysis
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