Advertisement

Journal of Cancer Research and Clinical Oncology

, Volume 140, Issue 7, pp 1205–1210 | Cite as

Prognostic significance of serum lactate dehydrogenase level in osteosarcoma: a meta-analysis

  • Jian Chen
  • Meng-xiong Sun
  • Ying-qi Hua
  • Zheng-dong Cai
Original Article – Clinical Oncology

Abstract

Background

A number of studies have investigated the role of serum lactate dehydrogenase (LDH) level in patients with osteosarcoma but have yielded inconsistent and inconclusive results. Thus, we conducted a meta-analysis to assess its prognostic value more precisely.

Methods

Systematic computerized searches of PubMed, Embase and Web of Science databases were performed. The pooled hazard ratio (HR) with 95 % confidence intervals (95 % CI) of overall survival was used to assess the prognostic role of serum LDH level.

Results

Ten studies published between 1997 and 2013 with a total of 943 osteosarcoma patients were included. Overall, the pooled HR for all ten eligible studies evaluating high LDH level on overall survival was 1.92(95 % CI 1.53–2.40). Sensitivity analysis suggested that the pooled HR was stable and omitting a single study did not change the significance of the pooled HR. Funnel plots and Egger’s tests revealed there was some possibility of publication bias risk in the meta-analysis.

Conclusion

This meta-analysis shows that high serum LDH level is obviously associated with lower overall survival rate in patients with osteosarcoma, and it is an effective biomarker of prognosis.

Keywords

LDH Osteosarcoma Prognosis Meta-analysis 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. Albain KS, Crowley JJ, LeBlanc M, Livingston RB (1990) Determinants of improved outcome in small-cell lung cancer: an analysis of the 2,580-patient Southwest oncology group data base. J Clin Oncol Off J Am Soc Clin Oncol 8:1563–1574Google Scholar
  2. Aparicio J, Segura A, Montalar J, Garcera S, Oltra A, Santaballa A, Yuste A, Pastor M, Munarriz B (1999) Long-term results after combined modality treatment for non-metastatic osteosarcoma. Med Oncol 16:255–260PubMedCrossRefGoogle Scholar
  3. Bacci G, Ferrari S, Longhi A, Rimondini S, Versari M, Zanone A, Forni C (1999) Prognostic significance of serum LDH in Ewing’s sarcoma of bone. Oncol Rep 6:807–811PubMedGoogle Scholar
  4. Chou AJ, Kleinerman ES, Krailo MD, Chen Z, Betcher DL, Healey JH, Conrad EU 3rd, Nieder ML, Weiner MA, Wells RJ et al (2009) Addition of muramyl tripeptide to chemotherapy for patients with newly diagnosed metastatic osteosarcoma: a report from the children’s oncology group. Cancer 115:5339–5348PubMedCentralPubMedCrossRefGoogle Scholar
  5. Dahlin DC, Unni KK (1977) Osteosarcoma of bone and its important recognizable varieties. Am J Surg Pathol 1:61–72PubMedCrossRefGoogle Scholar
  6. Durnali A, Alkis N, Cangur S, Yukruk FA, Inal A, Tokluoglu S, Seker MM, Bal O, Akman T, Inanc M et al (2013) Prognostic factors for teenage and adult patients with high-grade osteosarcoma: an analysis of 240 patients. Med Oncol 30:624PubMedCrossRefGoogle Scholar
  7. Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634PubMedCentralPubMedCrossRefGoogle Scholar
  8. Fellenberg J, Bernd L, Delling G, Witte D, Zahlten-Hinguranage A (2007) Prognostic significance of drug-regulated genes in high-grade osteosarcoma. Mod Pathol Off J US Can Acad Pathol 20:1085–1094Google Scholar
  9. Ferrari S, Ruggieri P, Cefalo G, Tamburini A, Capanna R, Fagioli F, Comandone A, Bertulli R, Bisogno G, Palmerini E et al (2012) Neoadjuvant chemotherapy with methotrexate, cisplatin, and doxorubicin with or without ifosfamide in nonmetastatic osteosarcoma of the extremity: an Italian sarcoma group trial ISG/OS-1. J Clin Oncol Off J Am Soc Clin Oncol 30:2112–2118CrossRefGoogle Scholar
  10. Garcia R, Hernandez JM, Caballero MD, Gonzalez M, Galende J, del Canizo MC, Vazquez L, San Miguel JF (1993) Serum lactate dehydrogenase level as a prognostic factor in Hodgkin’s disease. Br J Cancer 68:1227–1231PubMedCentralPubMedCrossRefGoogle Scholar
  11. Gonzalez-Billalabeitia E, Hitt R, Fernandez J, Conde E, Martinez-Tello F, Enriquez de Salamanca R, Cortes-Funes H (2009) Pre-treatment serum lactate dehydrogenase level is an important prognostic factor in high-grade extremity osteosarcoma. Clin Transl Oncol Off Publ Fed Span Oncol Soc Natl Cancer Inst Mexico 11:479–483Google Scholar
  12. Goorin AM, Schwartzentruber DJ, Devidas M, Gebhardt MC, Ayala AG, Harris MB, Helman LJ, Grier HE, Link MP, Pediatric Oncology G (2003) Presurgical chemotherapy compared with immediate surgery and adjuvant chemotherapy for nonmetastatic osteosarcoma: pediatric oncology group study POG-8651. J Clin Oncol Off J Am Soc Clin Oncol 21:1574–1580CrossRefGoogle Scholar
  13. Guo S, Bai R, Zhao W, Wang Y, Zhao Z, Feng W (2013) Prognostic role of cytovillin expression in patients with osteosarcoma: a meta-analysis. Tumour Biol J Int Soc Oncodev Biol Med 35:469CrossRefGoogle Scholar
  14. Hagleitner MM, Hoogerbrugge PM, van der Graaf WT, Flucke U, Schreuder HW, te Loo DM (2011) Age as prognostic factor in patients with osteosarcoma. Bone 49:1173–1177PubMedCrossRefGoogle Scholar
  15. Ilic I, Manojlovic S, Cepulic M, Orlic D, Seiwerth S (2004) Osteosarcoma and Ewing’s sarcoma in children and adolescents: retrospective clinicopathological study. Croat Med J 45:740–745PubMedGoogle Scholar
  16. Jiao G, Ren T, Lu Q, Sun Y, Lou Z, Peng X, Liang W, Guo W (2013) Prognostic significance of cyclooxygenase-2 in osteosarcoma: a meta-analysis. Tumour Biol J Int Soc Oncodev Biol Med 34:2489–2495CrossRefGoogle Scholar
  17. Kemeny N, Braun DW Jr (1983) Prognostic factors in advanced colorectal carcinoma. Importance of lactic dehydrogenase level, performance status, and white blood cell count. Am J Med 74:786–794PubMedCrossRefGoogle Scholar
  18. Mantel N, Haenszel W (1959) Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst 22:719–748PubMedGoogle Scholar
  19. McClelland GB, Khanna S, Gonzalez GF, Butz CE, Brooks GA (2003) Peroxisomal membrane monocarboxylate transporters: evidence for a redox shuttle system? Biochem Biophys Res Commun 304:130–135PubMedCrossRefGoogle Scholar
  20. Parmar MK, Torri V, Stewart L (1998) Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Stat Med 17:2815–2834PubMedCrossRefGoogle Scholar
  21. Pochanugool L, Subhadharaphandou T, Dhanachai M, Hathirat P, Sangthawan D, Pirabul R, Onsanit S, Pornpipatpong N (1997) Prognostic factors among 130 patients with osteosarcoma. Clin Orthop Relat Res 345:206–214PubMedCrossRefGoogle Scholar
  22. Qu JT, Wang M, He HL, Tang Y, Ye XJ (2012) The prognostic value of elevated vascular endothelial growth factor in patients with osteosarcoma: a meta-analysis and systemic review. J Cancer Res Clin Oncol 138:819–825PubMedCrossRefGoogle Scholar
  23. Ritter J, Bielack SS (2010) Osteosarcoma. Ann Oncol Off J Euro Soc Med Oncol ESMO 21(Suppl 7):vii320–vii325Google Scholar
  24. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg 73:712–716PubMedCrossRefGoogle Scholar
  25. Smaletz O, Scher HI, Small EJ, Verbel DA, McMillan A, Regan K, Kelly WK, Kattan MW (2002) Nomogram for overall survival of patients with progressive metastatic prostate cancer after castration. J Clin Oncol Off J Am Soc Clin Oncol 20:3972–3982CrossRefGoogle Scholar
  26. Stiller CA, Bielack SS, Jundt G, Steliarova-Foucher E (2006) Bone tumours in European children and adolescents, 1978-1997. Report from the Automated Childhood Cancer Information System project. Euro J Cancer 42:2124–2135CrossRefGoogle Scholar
  27. Tas F, Aykan F, Alici S, Kaytan E, Aydiner A, Topuz E (2001) Prognostic factors in pancreatic carcinoma: serum LDH levels predict survival in metastatic disease. Am J Clin Oncol 24:547–550PubMedCrossRefGoogle Scholar
  28. Walenta S, Mueller-Klieser WF (2004) Lactate: mirror and motor of tumor malignancy. Semin Radiat Oncol 14:267–274PubMedCrossRefGoogle Scholar
  29. Wen X, Liu H, Yu K, Liu Y (2014) Matrix metalloproteinase 2 expression and survival of patients with osteosarcoma: a meta-analysis. Tumour Biol J Int Soc Oncodev Biol Med 35:845–848CrossRefGoogle Scholar
  30. Wu PK, Chen WM, Chen CF, Lee OK, Haung CK, Chen TH (2009) Primary osteogenic sarcoma with pulmonary metastasis: clinical results and prognostic factors in 91 patients. Jpn J Clin Oncol 39:514–522PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Department of Orthopaedics, Shanghai First People’s HospitalNanjing Medical UniversityShanghaiChina

Personalised recommendations