Introduction/Background While the expression of tissue lactate dehydrogenase (LDH) is known to correlate with prognosis in endometrial cancer, the relationship between serum LDH and prognosis has not been well established.

Methodology This retrospective study analyzed 173 consecutive cases of endometrial cancer treated at our facility from 2005 to 2010. Patients were pathologically diagnosed and underwent hysterectomy, with 117 cases (67.6%) including lymphadenectomy, 51 cases (29.4%) undergoing hysterectomy alone, and 5 cases (2.9%) receiving other surgeries. Staging was distributed as follows: Stage I in 105 cases (60.7%), Stage II in 14 cases (8.1%), Stage III in 32 cases (18.4%), and Stage IV in 22 cases (12.7%). Postoperative adjuvant chemotherapy was administered in 106 cases (61.3%). The median follow-up period was 82 months, from 0.4 to 221 months.

Results Pre-treatment serum LDH levels were useful in predicting recurrence, with an area under the curve (AUC) of 0.686. The optimal cut-off value was identified as 217 U/L. Dividing patients into two groups based on this cut-off, the LDH-low group showed a significantly better prognosis with a 93.2% survival rate compared to 56.2% in the LDH-high group (P < 0.001). Serum LDH levels were significantly higher in advanced cancers (Stages III-IV) and in cases with myometrial invasion of more than half. Multivariate analysis revealed that, in addition to stage, serum LDH was an independent prognostic factor (P < 0.001).

Conclusion Serum LDH is a valuable prognostic marker in endometrial cancer and correlates with disease aggressiveness. Its use in clinical practice may aid in better tailoring treatment strategies and predicting outcomes.

Disclosures There are no COI to disclose.