Introduction & Objectives
Tumor biomarkers are of the utmost importance when diagnosing and staging testicular cancer. However, some refer to them as underutilized. Among the three main biomarkers for testicular cancer, Lactate Dehydrogenase (LDH) is considered the less specific, being mainly considered a predictor of tumor volume. This study aims to identify the relevance of LDH as a predictor of survival in Testicular Germ Cell Tumours (TGCT).
Materials & Methods
Seventy-seven clinical registries corresponding to patients orchiectomized in a tertiary center due to suspect of testicular cancer, diagnosed with TGCT, between January 2010 and November 2016 were studied. For every patient, when available, the pre- and post-operative biomarkers were registered. For post-operative marker stratification, the thresholds of TNM classifications for Serum Tumor Markers were utilized. All studied variables were subjected to normality tests and, as non-normal variables, the correlation test utilized was “Spearman Rank-order Correlation”, provided by SPSS v24.0.
Among the seventy-seven patients, seven died (9.1%). In our sample, there was no correlation between LDH value and tumor size. There was, however, a positive statistically significant correlation between LDH pre-operative absolute values and survival (p<0,01, ρ=0,379). Neither α-fetoprotein nor human Chorionic Gonadotropin (hCG) pre-operative values correlated with survival. Regarding post-operative markers, there was a positive statistically significant correlation between LDH staged by TNM and survival (p<0,01, ρ=0,549), which was stronger than the one attained by hCG (p=0,02, ρ=0,284).
While its low specificity may be considered a hurdle for more complex interpretations, LDH is a readily available biomarker with, as suggested by the results of this series, a potential for predictive interpretations. Therefore, larger studies that validate or result in a better insight of the marker trends should be performed.