Abstract
Background
Upper urinary tract urothelial carcinoma (UUTUC) is one of the uncommon malignancies
lacking of prognostic indicators. Lactate dehydrogenase (LDH) has been demonstrated
to correlate with clinical outcomes in human cancers. In this study, we aimed to evaluate
the prognostic implication of the preoperative LDH in UUTUC.
Patients and Methods
A cohort of 100 UUTUC samples along with the preoperative LDH value was recruited
from January 1990 to June 2011. The cutoff value was set at 245 u/L for the upper
value of normal limitation. Univariate and multivariate analyses were conducted to
determine the association of LDH with overall survival (OS) and disease-free survival
(DFS).
Results
Kaplan-Meier analysis revealed that high level of LDH (> 245 u/L) was significantly
associated with poor OS (P < .001) and DFS (P = .002). Multivariate Cox proportional analysis indicated LDH, controlled by vascular
invasion, pathological stage, lymph node status, subsequent bladder tumor, tumor grade,
tumor necrosis, architecture, and multifocality, was as an independent predictor of
OS (hazard ratio, 3.181; 95% confidence interval, 1.223-8.276; P = .018) and DFS (hazard ratio, 3.041; 95% confidence interval, 1.247-7.417; P = .015). Stratified showed that elevated serum LDH was correlated with the worse
OS in patients without lymph node metastasis (P = .002) and those at advanced pathological stage (P < .001).
Conclusion
The preoperative LDH was an independent prognostic factor for patients with UUTUC
and could be used as a risk factor to predict the tumor aggressiveness.
Keywords
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Article info
Publication history
Published online: January 21, 2016
Accepted:
January 16,
2016
Received in revised form:
December 28,
2015
Received:
August 7,
2015
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
