Preoperative serum-gamma-glutamyltransferase (GGT) does not represent an independent prognostic factor in a European cohort of patients with non-metastatic renal cell carcinoma.
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.
['Dalpiaz|Orietta|O|', 'Pichler|Martin|M|', 'Mrsic|Edvin|E|', 'Reitz|Daniel|D|', 'Krieger|Daniel|D|', 'Venturino|Luca|L|', 'Bezan|Angelika|A|', 'Stojakovic|Tatjana|T|', 'Pummer|Karl|K|', 'Zigeuner|Richard|R|', 'Hutterer|Georg C|GC|']
D000368:Aged D019540:Area Under Curve D001317:Austria D014408:Biomarkers, Tumor D002292:Carcinoma, Renal Cell D018572:Disease-Free Survival D005260:Female D006801:Humans D053208:Kaplan-Meier Estimate D007680:Kidney Neoplasms D008297:Male D015999:Multivariate Analysis D009336:Necrosis D060787:Neoplasm Grading D009367:Neoplasm Staging D011237:Predictive Value of Tests D016016:Proportional Hazards Models D012372:ROC Curve D012189:Retrospective Studies D012307:Risk Factors D013997:Time Factors D015854:Up-Regulation D044465:Whites D005723:gamma-Glutamyltransferase
RENAL CANCER TUMOUR MARKERS UROPATHOLOGY