Prognostic significance of preoperative serum gamma glutamyl transpeptidase level in patients with hepatocellular carcinoma after liver resection

Abstract

Objective To evaluate the prognostic significance of preoperative serum gamma glutamyl transpeptidase (GGT) level in patients with hepatocellular carcinoma (HCC) after liver resection. Methods A total of 432 patients undergoing hepatectomy for HCC were divided into normal GGT group (175 patients with GGT≤50 U/L) and high GGT group (257 patients with GGT>50 U/L). After balancing baseline characteristics by propensity score analysis, disease-free survival (DFS) and overall survival (OS) were compared between the two groups. Independent risk factors influencing DFS and OS were identified by Cox multivariate analyses. Results Propensity score analysis identified 124 matched pairs of patients from each group. In the propensity-matched cohort, DFS at 1, 3, and 5 years in normal GGT group (69.3%, 36.1%, 12.8%) was significantly higher than that in high GGT group (60.6%, 18.7%, 7.5%; P=0.039). OS at 1, 3, and 5 years in normal GGT group (90.7%, 73.7%, 66.1%) was also significantly higher than that in high GGT group (89.2%, 63.6%, 43.3%; P=0.024). COX multivariate analyses revealed that alpha-fetoprotein ≥400 ng/ml, GGT>50 U/L, macrovascular invasion, tumor size ≥10 cm, and tumor number ≥3 were independent risk factors for DFS in patients with HCC after liver resection. Albumin 50 U/L, macrovascular invasion, tumor size ≥10 cm, and tumor number ≥3 were identified as independent risk factors for OS. Conclusions Preoperative serum GGT level is an independent factor predicting tumor recurrence and long-term survival in HCC patients after liver resection. Key words: Carcinoma, hepatocellular; Gamma glutamyltransferase; Hepatectomy; Prognosis