Lactate dehydrogenase to albumin ratio as a prognostic indicator for patients with resectable non-small cell lung cancer.

Background: Serum lactate dehydrogenase to albumin ratio (LAR) is a newly discovered indicator that can comprehensively reflect the inflammatory or nutritional status of the body and has been proven to be associated with several diseases. This study aimed to investigate whether a high baseline LAR independently predicts worse prognosis in non-small cell lung cancer (NSCLC) patients undergoing radical surgery. Methods: This study retrospectively reviewed NSCLC patients who received radical surgery between January 2019 and October 2021 in our institution. Then, these patients were further categorized into low LAR and high LAR groups using X-tile software. Both univariate and multivariate logistic regression analyses were utilized to identify independent predictors of disease-free survival (DFS). A paired t-test was conducted to evaluate the changes in LAR after surgery. Results: A total of 233 patients were enrolled in this study. Patients with high baseline LAR had significantly worse DFS (P < 0.001) than those with low baseline LAR. According to Cox regression analysis, baseline LAR [hazard ratio (HR) 2.25, 95% confidence interval (CI) 1.01-5.01, P = 0.046] and tumor staging (HR 0.15, 95% CI 0.07-0.33, P < 0.001) were identified as independent predictors for DFS. Besides, based on the data of 97 patients who underwent their first follow-up at our hospital, cases with stage II/III tumors showed a significant decrease in LAR after surgery (P < 0.05), whereas no significant change was observed in stage I patients (P = 0.23). Conclusion: LAR emerged as a potential prognostic indicator for operable NSCLC patients. Cases with higher baseline LAR levels tend to have a poorer prognosis.