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Serum lactate dehydrogenase (LDH) level as a prognostic factor for the patients with advanced gastric cancer

Background: Though serum LDH level is frequently elevated in the patients with advanced gastric cancer, its clinical significance is still elusive. Moreover, the relationship between the change of serum LDH level after chemotherapy and the response to the treatment has not been studied, yet. We analyzed serum LDH level as a prognostic factor for the patients with advanced stomach cancer.

Methods: We assessed serum LDH level before chemotherapy for the patients who were planned to receive palliative chemotherapy. We re-assessed their serum LDH level at the time when the response to chemotherapy was evaluated after 2–4 cycles of treatment. The survival duration and the response to chemotherapy for the patients with low serum LDH level were compared to the survival duration and the response to chemotherapy for the patients with high serum LDH level. The relationship between the change of serum LDH level and the response to the treatment was evaluated, too. Results: Total 118 patients were entered into this study and 114 patients were evaluable for their response to chemotherapy.

Pre-treatment serum LDH level was normal in 88 patients and elevated in 30 patients. The response rate in the patients with high serum LDH level was significantly higher than the response rate in the patients with normal serum LDH level (34.5% versus 15.3%, p < 0.05). However, the patients with normal serum LDH level lived longer than the patients with high serum LDH level (median: 378 days versus 206 days, p < 0.001). The normalizing of the elevated serum LDH level after chemotherapy was related to the good response to treatment (response rate 50.0% versus 18.8%, p < 0.05).

Conclusions: For the patients with advanced gastric cancer, high serum LDH level was related to better response to chemotherapy but shorter survival duration. The normalization of elevated serum LDH level after chemotherapy was related to good response to treatment.

H. Lee, Y. Yuh and S. Kim
Sanggyepaik Hospital, seoul, Republic of Korea
Journal of Clinical Oncology, 2009 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 27, No 15S (May 20 Supplement), 2009: e15621