Significance of Serum Lactate Dehydrogenase-to-Albumin Ratio as a Prognostic Marker in Patients with Colon Cancer: A Prospective Cohort Study
DOI:
https://doi.org/10.51168/fkta7x35Keywords:
Colon cancer, Lactate dehydrogenase, Albumin, Lactate dehydrogenase-to-albumin ratio, Prognosis, BiomarkerAbstract
Background
Colon cancer remains a major cause of cancer-related morbidity and mortality worldwide. Prognostic biomarkers capable of identifying high-risk patients are essential for individualized treatment planning. The lactate dehydrogenase-to-albumin ratio (LAR), combining a marker of tumor metabolism and systemic inflammation with a marker of nutritional status, has emerged as a promising prognostic indicator.
Aim
To evaluate the prognostic significance of preoperative serum lactate dehydrogenase-to-albumin ratio in patients undergoing surgery for colon cancer.
Methods
A prospective observational study was conducted in the Department of General Surgery, IGIMS Patna, over two years. Seventy-two patients with histopathologically confirmed colon cancer undergoing curative surgery were included. Preoperative serum LDH and albumin levels were measured, and LAR was calculated. Patients were categorized into low-LAR and high-LAR groups using a cut-off value of 4.9. Associations between LAR and clinicopathological characteristics, postoperative outcomes, recurrence, and one-year survival were analyzed.
Results
Thirty patients (41.7%) had high LAR values. Advanced TNM stage, lymph node positivity, elevated CEA levels, and postoperative recurrence were significantly more frequent in the high-LAR group (p<0.05). One-year disease-free survival was significantly lower among patients with elevated LAR (63.3% vs. 90.5%; p=0.002).
Conclusion
Preoperative LAR is a simple, cost-effective, and reliable prognostic biomarker in colon cancer. Elevated LAR is associated with advanced disease, increased recurrence, and poorer survival outcomes.
Recommendations
Further multicenter studies with larger sample sizes and longer follow-up are recommended to validate the prognostic significance and optimal cut-off value of LAR.
Future research should assess whether LAR provides independent prognostic information beyond established clinicopathological factors.
References
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Copyright (c) 2026 Dr. Nadeem Ahmed, Dr. Anunay Kumar, Dr. Rajeev Ranjan, Dr. Kanchan Sone Lal Baitha, Dr. Prem Prakash, Dr. Rinku Kumari
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