Modeling the relationship between baseline lactate dehydrogenase and prognosis in patients with extensive-disease small cell lung cancer: a retrospective cohort study

Prognostic Significance of Lactate Dehydrogenase in Patients Undergoing Surgical Resection for Laryngeal Squamous Cell Carcinoma

The aim is to estimate the prognostic value of lactate dehydrogenase (LDH) in patients undergoing surgical resection for laryngeal squamous cell carcinoma (LSCC). A total of 640 resected LSCC patients were included. Preoperative lactate dehydrogenase (LDH) was assessed. Kaplan-Meier survival analysis and Cox regression analysis were conducted for overall survival (OS) and recurrence-free survival (RFS). Kaplan-Meier analysis, univariate analysis and multivariate analysis demonstrated significant prognostic value for preoperative LDH. Although LDH was predictor of OS, it failed to be a predictor of RFS. The univariate HR and 95% CI of LDH were 0.484 and 0.357-0.658 (P < 0.0001). The multivariate analysis showed that LDH (HR = 0.518, 95% CI: 0.380-0.705, p < 0.0001) was related to OS. Elevated preoperative LDH >132 IU/L was significantly associated with better survival. Preoperative LDH might be an independent prognostic marker of OS in LSCC patients undergoing surgical resection.

[Analysis of Correlation between TTF-1 and Sensitivity to First-line Chemotherapy and Prognosis in Patients with Small Cell Lung Cancer]

背景与目的

甲状腺转录因子-1（thyroid transcription factor-1, TTF-1）在非小细胞肺癌中被广泛研究，被认为是非小细胞肺癌的独立预后因子，但TTF-1在小细胞肺癌（small cell lung cancer, SCLC）中的预后价值研究较少。本研究旨在探讨TTF-1的表达状态与SCLC患者一线化疗敏感性及预后的关系。

方法

回顾性分析2017年1月1日-2019年1月1日在青岛大学附属医院确诊并治疗的、一线应用以铂类为基础的化疗的SCLC患者234例，随访患者临床特征及治疗、生存情况，采用χ²检验及Logistic回归模型分析TTF-1的表达状况与化疗反应率的关系，Kaplan-Meier法和Cox比例风险回归模型分析TTF-1的表达对患者生存期的影响。

结果

234例患者中，TTF-1阳性表达188例（80.3%, 188/234），TTF-1阴性表达46例（19.7%, 46/234），TTF-1阳性患者一线化疗客观反应率（objective response rate, ORR）高于阴性患者（70.7% vs 47.8%）（χ²=8.681, P=0.003）。Logistic回归多因素分析显示，TTF-1的表达是一线化疗ORR的独立预测因素（OR=0.216, 95%CI: 0.076-0.615, P=0.004），但此差异仅体现在局限期SCLC（limited-stage SCLC, LS-SCLC）中。TTF-1阴性表达患者中位无进展生存期（progression free survival, PFS）6.9个月短于TTF-1阳性表达患者的9.0个月（χ²=9.357, P=0.002）。TTF-1阴性组患者中位总生存期（overall survival, OS）13.3个月短于TTF-1阳性组患者的20.1个月（χ²=12.082, P=0.001）。

结论

TTF-1表达状态为SCLC患者一线化疗反应率及生存的独立预测因素，可能成为预测SCLC治疗疗效及预后的生物标志物。

Chinese Medicine Treatment Prolonged Survival in Small Cell Lung Cancer Patients: A Clinical Observation

OBJECTIVE

To evaluate the effect of Chinese medicine (CM) treatment on survival time and quality of life (QOL) in patients with small cell lung cancer (SCLC).

METHODS

This was an exploratory and prospective clinical observation. Patients diagnosed with SCLC receiving CM treatment were included and followed up every 3 months. The primary outcome was overall survival (OS), and the secondary outcomes were progression-free survival (PFS) and QOL.

RESULTS

A total of 136 patients including 65 limited-stage SCLC (LS-SCLC) patients and 71 extensive-stage SCLC (ES-SCLC) patients were analyzed. The median OS of ES-SCLC patients was 17.27 months, and the median OS of LS-SCLC was 40.07 months. The survival time was 16.27 months for SCLC patients with brain metastasis, 9.83 months for liver metastasis, 13.43 months for bone metastasis, and 18.13 months for lung metastasis. Advanced age, pleural fluid, liver and brain metastasis were risk factors, while longer CM treatment duration was a protective factor. QOL assessment indicated that after 6 months of CM treatment, scores increased in function domains and decreased in symptom domains.

CONCLUSION

CM treatment might help prolong OS of SCLC patients. Moreover, CM treatment brought the trend of symptom amelioration and QOL improvement. These results provide preliminary evidence for applying CM in SCLC multi-disciplinary treatment.

Serum Lactate Dehydrogenase Contributes to Prognostic Assessment in Patients With Oligometastatic Cancer and Brain Involvement

BACKGROUND/AIM

The aim of this study was to analyze the prognostic impact of serum lactate dehydrogenase (LDH) in patients with oligometastatic brain metastases, arbitrarily defined as max. Four brain lesions and 5 metastatic lesions overall.

PATIENTS AND METHODS

This was a retrospective single institution analysis. Overall, 42 patients were identified from a prospectively maintained database.

RESULTS

Seventeen patients (40%) had extracranial metastases. Twelve patients (29%) had elevated LDH (≥255 U/l). Their median survival was significantly shorter than that of patients with normal LDH. Due to an interaction with performance status, this result was separately confirmed in patients with performance status ≥70.

CONCLUSION

Oligometastatic disease is not always correctly diagnosed, because all radiological modalities are limited by certain thresholds for detection of small metastases. We hypothesize that LDH is associated with survival, because this biomarker may reflect the total burden of malignant disease. Future studies should examine whether or not ablative local treatment of oligometastases is warranted in patients with elevated LDH.

Central regulation of breast cancer growth and metastasis

Cancer is a systemic disease. In order to fully understand it, we must take a holistic view on how cancer interacts with its host. The brain monitors and responds to natural and aberrant signals arriving from the periphery, particularly those of metabolic or immune origin. As has been well described, a hallmark of cancer is marked disruption of metabolic and inflammatory processes. Depending on the salience and timing of these inputs, the brain responds via neural and humoral routes to alter whole-body physiology. These responses have consequences for tumor growth and metastasis, directly influencing patient quality of life and subsequent mortality. Additionally, environmental inputs such as light, diet, and stress, can promote inappropriate neural activity that benefits cancer. Here, I discuss evidence for brain-tumor interactions, with special emphasis on subcortical neuromodulator neural populations, and potential ways of harnessing this cross-talk as a novel approach for cancer treatment.