Evaluation of the relationship between lactate albumin dehydrogenase and response to treatment with tyrosine kinase inhibitors and prognosis in renal cell carcinomas

Introduction and Aim: This study was planned to evaluate the relationship of LDH/albumin ratio (LAR) with progression-free survival (PS) and overall survival (OS), as well as the relationship between post-treatment response and LAR in patients receiving tyrosine kinase inhibitor (TKI) therapy. Materials and Methods: In the study, all male and female patients over the age of 18, followed up with the diagnosis of renal cell cancer, with and without tyrosine kinase, were evaluated retrospectively. Using exclusion criteria, 64 patients were included in the study. The data were evaluated with the IBM SPSS version 25.0 statistical analysis program. The Mann-Whitney U test was used to compare independent groups. PS and OS were defined for survival analysis. Overall survival was estimated using the Kaplan-Meier method, and the Cox regression model was utilized to analyze independent prognostic risk factors. The optimal cut-off value for the LAR value was calculated as 47.53 using Roc analysis. Results: The median age of the patients was 62.5 and 51 (79.7%) were male. Mean overall survival was 45.94±6.28 (1.84-103.49) months; mean progression-free survival was 39.28±5.22 (1.84-105.24) months. The rate of progression was 72.7% in patients with LAR below 47.53, while it was 97.2% in patients with a LAR of 47.53 and above (p=0.010). LAR was 65.3 (25.8-220.28) in patients with mortality and 4.82 (23.5- 75.17) in survivors, significantly higher in patients with mortality than in survivors (p=0.005). The OS ratio of patients with LAR<47.53 was 51.9%, while it was 16.2% in patients with LAR≥47.53. PS ratio was 40.7% in patients with LAR<47.53 and 5.4% in patients with LAR≥47.53. In the Kaplan-Meier survival analysis, LAR≥47.53 was associated with poor OS and PS (p=0.010 and p=0.005, respectively). Although in univariate COX regression analysis LAR≥47.53 was seen to increase mortality 2.24 times (p=0.015), this was not statistically significant in multivariate analysis (p=0.619). TNM Stage 4 was found to be an independent predictive factor, significantly increasing mortality (OR=11.254; 95% CI: 3.22-39.327; p<0.001). Conclusion: The study shows the importance of detecting the disease at an early stage due to the high mortality of patients diagnosed at an advanced stage. Although high LAR values were associated with reduced survival, this was not statistically significant in multivariate analysis. Keywords: LAR, mortality, renal cell carcinoma