Serum lactate dehydrogenase is a predictor of poor survival in malignant melanoma.

Abstract

Recently, different studies suggested that the elevated serum concentration of lactate dehydrogenase (LDH) was associated with poor prognosis of melanoma. However, the results were controversial. We decided to perform a meta-analysis to assess the association between serum concentration of LDH and the overall survival (OS) of melanoma. Online electronic databases (PubMed, EMBASE, and Cochrane database) were searched. The association of LDH and the OS of melanoma was estimated by hazard ratio (HR) with its 95% confidence interval (CI). A total of 13 eligible studies with 4036 patients met the inclusion criteria. LDH level was significantly associated with OS in melanoma patients (HR=1.97, 95% CI 1.62-2.40, P<0.00001; I2=78%). In addition, LDH level was also significantly associated with OS in stage IV melanoma patients (HR=1.99, 95% CI 1.59-2.50, P<0.00001; I2=79%). In the subgroup analysis by study design, a statistically significant association was found in retrospective cohort studies (HR=2.31, 95% CI 1.18- 4.51, P=0.01; I2=87%) and in prospective cohort studies (HR=1.87, 95% CI 1.55-2.26, P<0.00001; I2=73%). In the subgroup analysis by sample size, LDH level was significantly associated with OS in large sample size studies (HR=1.61, 95% CI 1.17-2.23, P=0.003; I2=73%) and small sample size studies (HR=2.18, 95% CI 1.69-2.80, P <0.00001; I2=79%). In conclusion, this meta-analysis suggested that high LDH level might be a predictor of poor prognosis of melanoma patients.