Abstract
BackgroundThe prognostic value of lactate dehydrogenase levels in the prognosis of colorectal cancer patients has been assessed for years, although the results remain controversial and heterogeneous. Thus, we comprehensively reviewed the evidence from studies that evaluated lactate dehydrogenase levels in colorectal cancer patients to determine their effect.MethodsThe following databases were searched in September 2014 to identify studies that evaluated the prognostic value of lactate dehydrogenase levels in colorectal cancer: PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. We extracted hazard ratios (HRs) and the associated 95 % confidence intervals (CIs) from the identified studies, and performed random-effects model meta-analyses on the overall survival (OS) and progression-free survival (PFS). Thirty-two studies with a cumulative sample size of 8,261 patients were included in our analysis.ResultsOur meta-analyses revealed that high levels of lactate dehydrogenase were associated with poor OS (HR, 1.75; 95 % CI, 1.52–2.02) in colorectal cancer patients. However, this effect was not obvious in the OS of non-metastatic colorectal cancer patients (HR, 1.21; 95 % CI, 0.79–1.86). The prognostic value of lactate dehydrogenase levels on PFS was also not confirmed (HR, 1.36; 95 % CI, 0.98–1.87). Subgroup analyses revealed that the prognostic significance of lactate dehydrogenase was independent of study location, patient age, number of patients, metastasis, chemotherapy with anti-angiogenesis drugs, study type, or risk of bias.ConclusionsOur results indicate that high lactate dehydrogenase levels are associated with poor OS among colorectal cancer patients, although these levels are not significant predictors of PFS.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2276-3) contains supplementary material, which is available to authorized users.
Highlights
The prognostic value of lactate dehydrogenase levels in the prognosis of colorectal cancer patients has been assessed for years, the results remain controversial and heterogeneous
Eligibility criteria for inclusion in this meta-analysis were: [1] the study evaluated the correlation between lactate dehydrogenase levels and survival among Colorectal cancer (CRC) patients, [2] the study provided sufficient information for the estimation of hazard ratios (HRs) and their 95 % confidence intervals (CIs), and [3] the study was published in English, German, or French
Among the 32 studies that used serum lactate dehydrogenase levels to investigate their influence on patient prognosis, 2 studies [29, 30] used an immunohistochemistry method, and 1 study [30] used serum levels and immunohistochemistry methods
Summary
The prognostic value of lactate dehydrogenase levels in the prognosis of colorectal cancer patients has been assessed for years, the results remain controversial and heterogeneous. We comprehensively reviewed the evidence from studies that evaluated lactate dehydrogenase levels in colorectal cancer patients to determine their effect. Colorectal cancer (CRC) represents the third most common malignancy throughout the world [1]. The prognosis for late stage CRC is extremely poor, and survival is often measured in months once metastases are present. Elevated lactate dehydrogenase levels are consistently reported as a prognostic factor for poor survival among several cancer groups [7]. The authors conducted a prospective study, including various cancer types (liver, lung, bone, brain etc.), symptoms, signs and other serological variables, to evaluate LDH’s value as
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