Nomograms based on lactate dehydrogenase to albumin ratio for predicting survival in colorectal cancer

Abstract

Purpose:We aimed to determine if lactate dehydrogenase to albumin ratio (LAR) might play a prognostic role for patients with operable colorectal cancer (CRC). Patients and Methods: 1334 operable CRC patients in Wuhan Union Hospital Between July 2013 and September 2017 were enrolled in this study and were randomly appointed them into training (n=954) and validation (n=380) sets. The relationship between LAR and overall survival (OS) and disease-free survival (DFS) were determined by restricted cubic splines (RCS) with Cox regression models. LAR was then divided into three categories based on the RCS and compared to the well-known TNM stage system. Finally, survival nomograms were developed by compounding the LAR and other clinical factors. Results: Baseline LAR values and the all-cause mortality were U shaped, which slowly decreased until around 4.50 and then started to increase rapidly when the LAR ranged from 4.50-6.68 and then became flat thereafter (P for non-linearity <0.001). LAR was superior to TNM stage for OS as well as DFS and LAR plus TNM stage could add more net benefit than clinical model alone. Moreover, the survival nomograms based on LAR achieved great predictive ability for OS and DFS in operable CRC patients. Conclusions: LAR could be served as a reliable prognostic factor for OS as well as DFS, with more accurate prognostic prediction than current TNM stage for patients with operable CRC.

Utilizing the Lactate Dehydrogenase-to-Albumin Ratio for Survival Prediction in Patients with Bladder Cancer After Radical Cystectomy

“… 33 Thereafter, the prognostic significance of the LAR was validated in nasopharyngeal carcinoma, 34 , 35 gastric cancer, 36 and colorectal cancer. 37 , 38 In line with previous findings, our study provided additional evidence that the LAR could serve as an independent prognostic parameter in UCB, and the addition of the LAR to the prognostic nomograms would increase the predictive accuracies and clinical utilities.…”

“…It should be noted that the cutoff value of the LAR varied across studies. Different cutoff values of LAR were determined, including 5.5, 31 , 33 6.54, 32 4.04, 34 4.5, 37 4.91 38 and 3.67. 35 In our study, this value was 3.8.…”

Higher preoperative serum lactate dehydrogenase-to-albumin ratio was associated with worse overall survival for stage II gastric cancer

“…Gan W and Peng RR et al concluded that LAR was a valuable independent factor in radically resected hepatocellular carcinoma and nasopharyngeal carcinoma [22][23]. Similarly, studies demonstrated that the prognostic value of LAR in esophageal squamous cell carcinoma and colorectal cancer [21,[24][25]. Moreover, LAR was superior to the tumor node metastasis stage for predicting OS and DFS [25].…”

“…Similarly, studies demonstrated that the prognostic value of LAR in esophageal squamous cell carcinoma and colorectal cancer [21,[24][25]. Moreover, LAR was superior to the tumor node metastasis stage for predicting OS and DFS [25]. However, the effect of LAR on GC was less well reported.…”

“…Previous studies have demonstrated that LAR is associated with hepatocellular carcinoma, nasopharyngeal carcinoma, esophageal squamous cell carcinoma, and colorectal cancer [21][22][23][24][25].…”