Prognostic Value of Lactate Dehydrogenase in Advanced Esophageal Squamous Cell Carcinoma Patients with Immunotherapy

Background The overall efficacy of immunotherapy is unsatisfactory in patients with advanced esophageal squamous cell carcinoma (ESCC) , since only a few cases could obtain benefits from the therapy. Therefore, it is of great importance to select effective prognostic indicators. Objective To investi...

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Main Author: Yan LI, Kunlun WANG, Hui YANG, Erjiang ZHAO, Bingxu LI, Shenglei LI, Xiaotao DONG, Ling YUAN
Format: Article
Language:zho
Published: Chinese General Practice Publishing House Co., Ltd 2022-09-01
Series:Zhongguo quanke yixue
Subjects:
Online Access:https://www.chinagp.net/fileup/1007-9572/PDF/1658364679583-243027300.pdf
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author Yan LI, Kunlun WANG, Hui YANG, Erjiang ZHAO, Bingxu LI, Shenglei LI, Xiaotao DONG, Ling YUAN
author_facet Yan LI, Kunlun WANG, Hui YANG, Erjiang ZHAO, Bingxu LI, Shenglei LI, Xiaotao DONG, Ling YUAN
author_sort Yan LI, Kunlun WANG, Hui YANG, Erjiang ZHAO, Bingxu LI, Shenglei LI, Xiaotao DONG, Ling YUAN
collection DOAJ
description Background The overall efficacy of immunotherapy is unsatisfactory in patients with advanced esophageal squamous cell carcinoma (ESCC) , since only a few cases could obtain benefits from the therapy. Therefore, it is of great importance to select effective prognostic indicators. Objective To investigate the prognostic value of lactate dehydrogenase (LDH) in advanced ESCC patients with immunotherapy. Methods This study enrolled patients diagnosed with advanced ESCC by pathological and imaging examinations in Henan Cancer Hospital from October 2016 to October 2019. Data were collected, including baseline data obtained from the electronic medical record system, LDH level at the 8th week of immunotherapy, and results〔containing death, disease remission, progression-free survival (PFS) and overall survival (OS) 〕 of a follow-up until August 31, 2021. Log-rank test was used to compare Kaplan-Meier curves of PFS and OS by baseline LDH. Multivariate Cox regression analysis was used to analyze the potential factors associated with PFS and OS. Results Of the 44 cases enrolled, a higher objective response rate was found in those with lower baseline LDH (n=28, baseline LDH<200 U/L) instead of those with higher baseline LDH (n=16, baseline LDH≥200 U/L) (χ2=8.522, P=0.013) . Eight patients with disease progression (PD) had higher ?LDH than 36 patients without PD (t=2.394, P=0.021) . At the end of follow-up, 9 patients (20.5%) survived, with a median PFS of 6 (2, 11) months, and a median OS of 11 (7, 18) months. PFS was significantly different in those with higher and lower baseline LDH levels (χ2=6.790, P=0.009) . OS was also significantly different in those with higher and lower baseline LDH levels (χ2=12.327, P<0.001) . The baseline LDH〔HR=2.686, 95%CI (1.274, 5.664) , P=0.009〕was associated with the PFS after immuotherapy. And the multivariate analyses showed that baseline LDH〔HR=17.440, 95%CI (2.254, 134.962) , P=0.001〕, hemoglobin〔HR=0.005, 95%CI (<0.001, 0.120) , P=0.001〕, monocyte count〔HR=0.066, 95%CI (0.008, 0.525) , P=0.010〕were associated with the OS after immunotherapy (P<0.05) . Conclusion Baseline LDH may be used as a prognostic marker after immunotherapy in patients with advanced ESCC, and a lower baseline LDH may be associated with longer PFS and OS.
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spelling doaj.art-1e44e44db5914c778cb2a6b05a6ecd2a2024-04-09T04:03:16ZzhoChinese General Practice Publishing House Co., LtdZhongguo quanke yixue1007-95722022-09-0125263263326910.12114/j.issn.1007-9572.2022.0293Prognostic Value of Lactate Dehydrogenase in Advanced Esophageal Squamous Cell Carcinoma Patients with ImmunotherapyYan LI, Kunlun WANG, Hui YANG, Erjiang ZHAO, Bingxu LI, Shenglei LI, Xiaotao DONG, Ling YUAN01. Department of Oncological Radiotherapy, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China;2. Case Room, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China;3. Department of Radiation Oncology, Anyang Cancer Hospital, Anyang 455000, ChinaBackground The overall efficacy of immunotherapy is unsatisfactory in patients with advanced esophageal squamous cell carcinoma (ESCC) , since only a few cases could obtain benefits from the therapy. Therefore, it is of great importance to select effective prognostic indicators. Objective To investigate the prognostic value of lactate dehydrogenase (LDH) in advanced ESCC patients with immunotherapy. Methods This study enrolled patients diagnosed with advanced ESCC by pathological and imaging examinations in Henan Cancer Hospital from October 2016 to October 2019. Data were collected, including baseline data obtained from the electronic medical record system, LDH level at the 8th week of immunotherapy, and results〔containing death, disease remission, progression-free survival (PFS) and overall survival (OS) 〕 of a follow-up until August 31, 2021. Log-rank test was used to compare Kaplan-Meier curves of PFS and OS by baseline LDH. Multivariate Cox regression analysis was used to analyze the potential factors associated with PFS and OS. Results Of the 44 cases enrolled, a higher objective response rate was found in those with lower baseline LDH (n=28, baseline LDH<200 U/L) instead of those with higher baseline LDH (n=16, baseline LDH≥200 U/L) (χ2=8.522, P=0.013) . Eight patients with disease progression (PD) had higher ?LDH than 36 patients without PD (t=2.394, P=0.021) . At the end of follow-up, 9 patients (20.5%) survived, with a median PFS of 6 (2, 11) months, and a median OS of 11 (7, 18) months. PFS was significantly different in those with higher and lower baseline LDH levels (χ2=6.790, P=0.009) . OS was also significantly different in those with higher and lower baseline LDH levels (χ2=12.327, P<0.001) . The baseline LDH〔HR=2.686, 95%CI (1.274, 5.664) , P=0.009〕was associated with the PFS after immuotherapy. And the multivariate analyses showed that baseline LDH〔HR=17.440, 95%CI (2.254, 134.962) , P=0.001〕, hemoglobin〔HR=0.005, 95%CI (<0.001, 0.120) , P=0.001〕, monocyte count〔HR=0.066, 95%CI (0.008, 0.525) , P=0.010〕were associated with the OS after immunotherapy (P<0.05) . Conclusion Baseline LDH may be used as a prognostic marker after immunotherapy in patients with advanced ESCC, and a lower baseline LDH may be associated with longer PFS and OS.https://www.chinagp.net/fileup/1007-9572/PDF/1658364679583-243027300.pdfesophageal neoplasms|esophageal squamous cell carcinoma|immunotherapy|programmed death -1|lactate dehydrogenases|clinical reaction|prognosis|progress-free survival|overall survival
spellingShingle Yan LI, Kunlun WANG, Hui YANG, Erjiang ZHAO, Bingxu LI, Shenglei LI, Xiaotao DONG, Ling YUAN
Prognostic Value of Lactate Dehydrogenase in Advanced Esophageal Squamous Cell Carcinoma Patients with Immunotherapy
Zhongguo quanke yixue
esophageal neoplasms|esophageal squamous cell carcinoma|immunotherapy|programmed death -1|lactate dehydrogenases|clinical reaction|prognosis|progress-free survival|overall survival
title Prognostic Value of Lactate Dehydrogenase in Advanced Esophageal Squamous Cell Carcinoma Patients with Immunotherapy
title_full Prognostic Value of Lactate Dehydrogenase in Advanced Esophageal Squamous Cell Carcinoma Patients with Immunotherapy
title_fullStr Prognostic Value of Lactate Dehydrogenase in Advanced Esophageal Squamous Cell Carcinoma Patients with Immunotherapy
title_full_unstemmed Prognostic Value of Lactate Dehydrogenase in Advanced Esophageal Squamous Cell Carcinoma Patients with Immunotherapy
title_short Prognostic Value of Lactate Dehydrogenase in Advanced Esophageal Squamous Cell Carcinoma Patients with Immunotherapy
title_sort prognostic value of lactate dehydrogenase in advanced esophageal squamous cell carcinoma patients with immunotherapy
topic esophageal neoplasms|esophageal squamous cell carcinoma|immunotherapy|programmed death -1|lactate dehydrogenases|clinical reaction|prognosis|progress-free survival|overall survival
url https://www.chinagp.net/fileup/1007-9572/PDF/1658364679583-243027300.pdf
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