ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1610487
This article is part of the Research TopicCancer Immunity, Modern Radiotherapy and Immunotherapy: A Journey into Cancer Treatment InnovationView all articles
Prognostic Value of the Lactate Dehydrogenase to Albumin Ratio in Cancer Patients
Provisionally accepted
- 1Renmin Hospital of Wuhan University, Wuhan, China
- 2Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
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Objective: This study aimed to explore the prognostic relevance of the lactate dehydrogenase-to-albumin ratio (LAR) in cancer patients.Methods: A comprehensive literature search was conducted across PubMed, EMBASE, and the Cochrane Library for studies published before March 15, 2025. The primary outcomes included pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for overall survival (OS), progression-free survival (PFS), and recurrence-free survival (RFS). In addition, a retrospective cohort of 71 hepatocellular carcinoma (HCC) patients treated with immune checkpoint inhibitors at our institution was analyzed to assess the prognostic impact of baseline LAR on OS and PFS.Results: Eighteen studies comprising 8,335 patients were incorporated into the metaanalysis. Elevated LAR was consistently associated with poorer outcomes: OS (HR: 2,02, 95% CI: 1.74-2.34, p < 0.001), PFS (HR = 1.35, 95% CI: 1.14-1.61, p < 0.001), and RFS (HR = 1.97, 95% CI: 1.47-2.64, p < 0.001). Subgroup evaluations stratified by LAR thresholds, geographical regions, treatment regimens, and statistical models confirmed the robustness of these associations. In our institutional cohort, patients presenting with pretreatment higher LAR experienced significantly diminished OS (HR = 2.04, 95% CI: 1.19-3.57, p = 0.008) and PFS (HR = 1.89, 95% CI: 1.14-3.13, p = 0.01) compared with those having lower LAR levels.These findings underscore the prognostic value of pretreatment LAR in cancer patients. Integrating LAR into clinical decision-making may aid clinicians in enhancing risk stratification and personalizing treatment strategies.
Keywords: immune checkpoint inhibitors, Cancer, lactate dehydrogenase to albumin ratio, prognosis, Hepatocellular Carcinoma
Received: 15 Apr 2025; Accepted: 12 Jun 2025.
Copyright: © 2025 Chai, Zhang, Hui, Yang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Lilong Zhang, Renmin Hospital of Wuhan University, Wuhan, China
Weixing Wang, Renmin Hospital of Wuhan University, Wuhan, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.