Abstract
Aim: To assess the prognostic value of the pretreatment serum γ-glutamyltranspeptidase (GGT) level in patients with primary liver cancer (PLC). Methods: Relevant studies were systematically searched online on Web of Science, PubMed, and Embase databases published until 9 October 2018. The end points were overall survival (OS), recurrence-free survival (RFS), and disease-free survival (DFS). Meta-analysis was conducted using hazard ratio (HR), and its 95% confidence interval (CI) as effect measure. Results: A total of 33 eligible studies with 9238 patients with PLC were included in this meta-analysis. The synthesized analysis showed that that higher serum GGT level was significantly related to poorer OS (HR: 1.79, 95% CI: 1.66–1.93, P<0.01), RFS (HR: 1.60, 95% CI: 1.46–1.77, P<0.01), and DFS (HR: 1.52, 95% CI: 1.33–1.73, P<0.01) of patients with PLC. Subgroup analyses demonstrated that the negative prognostic impact of higher serum GGT level on OS and RFS was still of significance regardless of ethnicity, pathological type, sample size, cut-off value, first-line treatment, and analysis type. Conclusion: The pretreatment serum GGT might be a predictive factor of poor prognosis for PLC patients.
Highlights
Primary liver cancer (PLC), including hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC), is one of the most common human malignant neoplasms [1]
Articles meeting the following criteria were defined as eligible ones for this meta-analysis: (i) cohort study or observational study; (ii) tumors were confirmed as HCC or ICC through histology; (iii) studies reported the relationship between serum GGT level and prognosis of PLC patients; and (iv) studies provided hazard ratio (HR) estimation with 95% confidence interval (CI) of overall survival (OS), disease-free survival (DFS), or recurrence-free survival (RFS)
The results of this meta-analysis demonstrated that a higher serum GGT is a useful biomarker for poorer OS, RFS, and DFS in PLC patients and this result would not change substantially when any eligible study was sequentially omitted in sensitivity analysis
Summary
Primary liver cancer (PLC), including hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC), is one of the most common human malignant neoplasms [1]. A comprehensive therapy integrating surgical resection, thermal ablative techniques, chemotherapy, and molecular-targetted therapy has been applied to deal with patients with PLC in recent years, the long-term survival of patients remains rather unfavorable [2,3]. It is of great importance to identify biomarkers for accurately predicting the prognosis of patients with PLC, which may contribute to optimizing individual treatment and improve the long-term outcomes. Several researchers reported that GGT might be involved in contributing to the tumor initiation, progression, invasion, and drug resistance [5–7]. Increased serum level of GGT was found to be linked with worse prognosis in several human malignancies, including PLC
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