Prognostic impact of lactic dehydrogenase to albumin ratio in hepatocellular carcinoma patients with Child–Pugh I who underwent curative resection: a prognostic nomogram study

Abstract

BackgroundRadical resection is the treatment of choice for hepatocellular carcinoma (HCC). However, even with this treatment, HCC prognosis and the efficacy of current predictive models for such patients remain unsatisfactory. Here, we describe an accurate and easy-to-use prognostic index for patients with HCC who have undergone curative resection.MethodsThe study population comprised of 1,041 patients with HCC who underwent curative resection at Zhongshan Hospital. This population was reduced to 768 patients who were treated in 2012 analyzed as the training cohort and 273 patients treated in 2007 who were used as a validation cohort.ResultsThe lactic dehydrogenase to albumin ratio (LAR) was identified as a significant prognostic index for both overall survival and recurrence-free survival in two independent cohorts. The optimal cutoff value for LAR was determined to be 5.5. The C-index of LAR was superior to other inflammatory scores and serum parameters. This biomarker was also shown to be a stable predictive index in the validation cohort. The new nomogram combining LAR with the Barcelona Clinic Liver Cancer staging system had an improved ability to discriminate overall survival and recurrence-free survival. Nomogram predictions were consistent with observations based on calibration and decisive curve analysis in both independent cohorts.ConclusionLAR is a novel, convenient, reliable, and accurate prognostic predictor in patients with HCC undergoing curative resection. Our results suggest the recommendation of LAR to be used in routine clinical practice.

Nomogram Based on Systemic Immune Inflammation Index and Prognostic Nutrition Index Predicts Recurrence of Hepatocellular Carcinoma After Surgery

“…Studies have shown that malnutrition often leads to poor tumor prognosis ( 24 ). In studying the HCC clinical nomogram model, albumin-based nutritional indexes, including the albumin-bilirubin grade and lactic dehydrogenase/albumin ratio, showed good prognostic predictive performance ( 25 , 26 ). In this study, we explored the albumin-based PNI.…”

Prognostic significance of pretreatment serum lactate dehydrogenase-to-albumin ratio in gastric cancer

“…In another study, Gan et al . [ 14 ] found that increased LAR levels were associated with a poor prognosis in patients with hepatocellular cancer. In both of these studies, the cutoff value for LAR was determined as 5.5.…”

“…The LDH-to-albumin ratio (LAR) is a prognostic tool used in cancer patients. Elevated LAR levels have been associated with poor prognosis in esophageal and hepatocellular cancers [ 13 , 14 ]. Nevertheless, to our knowledge, there are a limited number of studies reporting on the prognostic value of LAR, and there has been no study specifically reporting on the effect of LAR on prognosis in patients with gastric cancer.…”

The prognostic significance of serum lactate dehydrogenase-to-albumin ratio in colorectal cancer

“…With a high LDH-to-albumin ratio, survival is expected to be poor. Although there is little or no documentation of the LDH-to-albumin ratio in the literature, LDH-to-albumin ratio has been shown to be associated with a poor prognosis in esophageal and hepatocellular cancers [ 20 21 ].…”

“…The authors determined a cutoff value of 5.5 for LDH-to-albumin ratio and suggested that LDH and albumin alone had no effect on the prognosis of the disease [20]. In another study, Gan et al [21] found that high LDH-to-albumin ratio was associated with poor prognosis in patients with hepatocellular cancer. The drawback of that study is that both LDH and albumin levels could be affected by the presence of the underlying chronic liver disease regardless of the tumor.…”