Prognostic significance of serum gamma-glutamyl transferase in patients with intermediate hepatocellular carcinoma treated with transcatheter arterial chemoembolization

Objectives Not every unresectable hepatocellular carcinoma (HCC) could receive survival benefits from transcatheter arterial chemoembolization (TACE), even for intermediate HCC (Barcelona Clinic Liver Cancer stage B). The aim of this study was to investigate prognostic significance of serum gamma-glutamyl transferase (GGT) in patients with intermediate HCC treated with TACE. Methods A total of 277 patients with intermediate HCC were consecutively treated with TACE and overall survival (OS) was evaluated with the Kaplan-Meier method. Significant difference was estimated with the Log rank method according to GGT value before treatment. Univariate and multivariate analyses were used for the study of significance of prognostic factor. Results The median follow-up period was 18.7 months. The 1-year and 3-year OS rates were 71.6 and 38.5% in patients with normal GGT and 48.8 and 16.9% in patients with high GGT (P = 0.002). High GGT, correlating with higher tumor size, alpha-fetoprotein (AFP), and alanine aminotrasferase, was an independent prognostic factor for OS (P = 0.009). Others included tumor size and ascites. Furthermore, in small HCC and normal AFP subgroup, serum GGT was also correlated with OS (P = 0.013 and 0.041, respectively). The combination of GGT and AFP had a better power to predict the TACE effects. Conclusion GGT level was an important prognostic factor to predict prognosis of patients with intermediate HCC treated with TACE. Eur J Gastroenterol Hepatol 23: 787-793 (C) 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.