Pleural LDH as a prognostic marker in adenocarcinoma lung with malignant pleural effusion

Pleural LDH as a prognostic marker in adenocarcinoma lung with malignant pleural effusion

To study the performance of serum and pleural lactate dehydrogenase (LDH) level in predicting survival in patients with adenocarcinoma lung presenting with malignant pleural effusions (MPE) at initial diagnosis.Retrospective cohort study of the patient hospitalized for adenocarcinoma lung with MPE i...

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Published in:Medicine (Baltimore) Vol. 95; no. 26; p. e3996
Main Authors: Verma, Akash, Phua, Chee Kiang, Sim, Wen Yuan, Algoso, Reyes Elmer, Tee, Kuan Sen, Lew, Sennen J W, Lim, Albert Y H, Goh, Soon Keng, Tai, Dessmon Y H, Kor, Ai Ching, Ho, Benjamin, Abisheganaden, John
Format: Journal Article
Language:English
Published: United States Wolters Kluwer Health 01-06-2016
Subjects:
Adenocarcinoma - enzymology
Adenocarcinoma - mortality
Adenocarcinoma of Lung
Adult
Aged
Aged, 80 and over
Biomarkers - analysis
Cohort Studies
Female
Humans
L-Lactate Dehydrogenase - analysis
L-Lactate Dehydrogenase - blood
Lung Neoplasms - enzymology
Lung Neoplasms - mortality
Male
Middle Aged
Observational Study
Pleural Effusion, Malignant - blood
Pleural Effusion, Malignant - enzymology
Prognosis
Retrospective Studies
Sex Factors
Survival Rate
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Summary:To study the performance of serum and pleural lactate dehydrogenase (LDH) level in predicting survival in patients with adenocarcinoma lung presenting with malignant pleural effusions (MPE) at initial diagnosis.Retrospective cohort study of the patient hospitalized for adenocarcinoma lung with MPE in year 2012.Univariate analyses showed lower pleural fluid LDH 667 (313-967) versus 971 (214-3800), P = 0.04, female gender 9 (100%) versus 27 (41.5%), P = 0.009, never smoking status 9 (100%) versus 36 (55.3%), P = 0.009, and epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy 8 (89%) versus 26 (40%), P = 0.009 to correlate with survival of more than 1.7 year versus less than 1.7 year. In multivariate analysis, low pleural fluid LDH and female gender maintained significance. The pleural LDH level of ≤1500 and >1500 U/L discriminated significantly (P = 0.009) between survival.High pleural LDH (>1500 IU/L) predicts shorter survival (less than a year) in patients with adenocarcinoma lung presenting with MPE at the time of initial diagnosis. This marker may be clinically applied for selecting therapeutic modality directed at prevention of reaccumulation of MPE. Patients with low pleural LDH may be considered suitable for measures that provide more sustained effect on prevention of reaccumulation such as chemical pleurodesis or tunneled pleural catheter.
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ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000003996