PRETREATMENT SERUM LDH AS ADDITIONAL STAGING PARAMETER IN SMALL-CELL LUNG-CARCINOMA

Background: In patients with limited disease staged small-cell lung ca ncer (SCLC), overall survival is still poor. Therefore, a retrospectiv e study was carried out of 48 patients with limited disease staged SCL C to select a parameter which can identify prognostic subgroups at the time of diagnosis. Materials and Methods: Follow-up varied from 3 to 96 months during which 38 patients died. Based on clinical outcome, pa tients were clustered into three groups: complete remission (CR) (n = 16); local recurrence (LOC) (n = 7); and distant recurrence (DIS) (n = 25). Age, gender and pretreatment biochemical parameters were correla ted with clinical outcome and survival. Results: No differences in sur vival were found in patients with LOC (14% 2-year survival) and DIS (1 6% 2-year survival) (P = 0.67). Patients with complete remission demon strated a significantly better survival (75% 2-year survival). LDH was found to be the only significant correlate of both tumour progression and survival. All patients with pretreatment LDH levels > 240 IU/l (n = 13) demonstrated tumour recurrence. The survival rate of patients w ith LDH levels < 240 IU/l (41% 2-year survival) was much better than t hat of patients with LDH levels > 240 IU/l (8% 2-year survival) (P = 0 .0001). Conclusion: LDH may be used for the identification of prognost ic subgroups in limited disease SCLC. Patients showing pretreatment LD H levels > 240 IU/l have an extremely high risk of tumour recurrence, whereas survival is poor. In patients with LDH levels, < 240 IU/l surv ival is significantly better. (C) 1998 Elsevier Science B.V.