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Preoperative serum-gamma-glutamyltransferase (GGT) does not represent an independent prognostic factor in a European cohort of patients with non-metastatic renal cell carcinoma
  1. Orietta Dalpiaz1,
  2. Martin Pichler2,3,
  3. Edvin Mrsic1,
  4. Daniel Reitz2,
  5. Daniel Krieger1,
  6. Luca Venturino1,
  7. Angelika Bezan2,
  8. Tatjana Stojakovic4,
  9. Karl Pummer1,
  10. Richard Zigeuner1,
  11. Georg C Hutterer1
  1. 1Department of Urology, Medical University of Graz, Graz, Austria
  2. 2Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
  3. 3Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  4. 4Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
  1. Correspondence to Dr Martin Pichler, Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz A-8036, Austria; martin.pichler{at}medunigraz.at

Abstract

Aims Increasing evidence suggests that the serum-gamma-glutamyltransferase (GGT) might correlate with tumour development and growth rates in various human cancer types. Thus, we decided to investigate the potential prognostic impact of the preoperatively assessed serum-GGT in a European cohort of patients with non-metastatic renal cell carcinoma (RCC).

Methods Clinicopathological data from 700 consecutive patients with non-metastatic RCC, operated between 2000 and 2010 at a single tertiary academic centre, were evaluated retrospectively. Preoperative serum-GGT was assessed 1 day before surgery. Patients were categorised using a serum-GGT cut-off value of 40 U/L according to a calculation by receiver operating curve analysis. Patients’ cancer-specific survival (CSS), metastasis-free survival (MFS), as well as overall survival (OS) were assessed using the Kaplan-Meier method and Cox proportional models.

Results In univariate analysis, an elevated preoperative serum-GGT level (<40 U/L vs ≥40 U/L) was statistically significantly associated with a shorter MFS (HR=1.517, 95% CI 1.047 to 2.197, p=0.027). In multivariate analyses, pathological T-Stage (pT-1 vs pT-2–4, HR=2.065, 95% CI 1.665 to 2.560), tumour grade (G-1+G-2 vs G-3+G-4, HR=1.671, 95% CI 1.261 to 2.213), as well as the presence of histological tumour necrosis (No vs Yes, HR=2.031, 95% CI 1.355 to 3.046) were independent predictors of MFS in patients with RCC, whereas the preoperative serum-GGT failed to reach independent predictor status (<40 U/L vs ≥40 U/L, HR=1.156, 95% CI 0.791 to 1.690). No prognostic role for GGT in OS or CSS could be identified.

Conclusions In the cohort studied, patients with an elevated (≥40 U/L) preoperative serum-GGT had a subsequently shorter MFS only in univariate analysis. In contrast to previous studies, our data failed to demonstrate preoperatively assessed serum-GGT as an independent prognostic factor in patients with non-metastatic RCC.

  • UROPATHOLOGY
  • RENAL CANCER
  • TUMOUR MARKERS

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