Elevated lactic acid is a negative prognostic factor in metastatic lung cancer

Area of Science:

• Oncology
• Medical Diagnostics
• Biochemistry

Background:

• Hyperlactatemia, a rare cancer complication, is typically observed in hematological malignancies.
• This study investigates the prognostic significance of lactic acid (LA) in metastatic lung cancer.

Purpose of the Study:

• To determine the prognostic value of lactic acid (LA) levels in patients with metastatic lung cancer.
• To assess the association between hyperlactatemia and overall survival (OS) in non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC).

Main Methods:

• Retrospective analysis of 85 patients with stage IV NSCLC or extensive stage SCLC.
• Recorded arterial/venous LA levels, anion gap (AG), serum lactate dehydrogenase (LDH), and urine ketones.
• Examined associations between LA levels, clinical data, and overall survival (OS).

Main Results:

• Elevated LA levels correlated with increased metastatic sites, ICU admission, intubation, and higher AG and LDH.
• Hyperlactatemia (≥ 1.4 mmol/L) was significantly associated with shorter OS (log-rank p<0.001).
• LA remained an independent predictor of poor survival in multivariate analysis (OR: 1.3; p=0.005), alongside performance status and chemotherapy.

Conclusions:

• High lactic acid levels (≥ 1.4 mmol/L) are associated with significantly shorter overall survival in metastatic lung cancer.
• Hyperlactatemia serves as an independent predictor of poor survival in patients with metastatic NSCLC and SCLC.