Pretherapeutic gamma-glutamyltransferase is an independent prognostic factor for patients with renal cell carcinoma.

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Etat: Serval
Version: Final published version
ID Serval
serval:BIB_8F715C43D92F
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Pretherapeutic gamma-glutamyltransferase is an independent prognostic factor for patients with renal cell carcinoma.
Périodique
British Journal of Cancer
Auteur(s)
Hofbauer S.L., Stangl K.I., de Martino M., Lucca I., Haitel A., Shariat S.F., Klatte T.
ISSN
1532-1827 (Electronic)
ISSN-L
0007-0920
Statut éditorial
Publié
Date de publication
2014
Peer-reviewed
Oui
Volume
111
Numéro
8
Pages
1526-1531
Langue
anglais
Notes
Publication types: Journal Article Publication Status: ppublish
Résumé
BACKGROUND: Gamma-glutamyltransferase (GGT) regulates apoptotic balance and promotes cancer progression and invasion. Higher pretherapeutic GGT serum levels have been associated with worse outcomes in various malignancies, but there are no data for renal cell carcinoma (RCC).
METHODS: Pretherapeutic GGT serum levels and clinicopathological parameters were retrospectively evaluated in 921 consecutive RCC patients treated with nephrectomy at a single institution between 1998 and 2013. Gamma-glutamyltransferase was analysed as continuous and categorical variable. Associations with RCC-specific survival were assessed with Cox proportional hazards models. Discrimination was measured with the C-index. Decision-curve analysis was used to evaluate the clinical net benefit. The median postoperative follow-up was 45 months.
RESULTS: Median pretherapeutic serum GGT level was 25 U l(-1). Gamma-glutamyltransferase levels increased with advancing T (P<0.001), N (P=0.006) and M stages (P<0.001), higher grades (P<0.001), and presence of tumour necrosis (P<0.001). An increase of GGT by 10 U l(-1) was associated with an increase in the risk of death from RCC by 4% (HR 1.04, P<0.001). Based on recursive partitioning-based survival tree analysis, we defined four prognostic categories of GGT: normal low (<17.5 U l(-1)), normal high (17.5 to <34.5 U l(-1)), elevated (34.5 to <181.5 U l(-1)), and highly elevated (⩾181.5 U l(-1)). In multivariable analyses that adjusted for the effect of standard features, both continuously and categorically coded GGT were independent prognostic factors. Adding GGT to a model that included standard features increased the discrimination by 0.9% to 1.8% and improved the clinical net benefit.
CONCLUSIONS: Pretherapeutic serum GGT is a novel and independent prognostic factor for patients with RCC. Stratifying patients into prognostic subgroups according to GGT may be used for patient counselling, tailoring surveillance, individualised treatment planning, and clinical trial design.
Mots-clé
Aged, Carcinoma, Renal Cell/enzymology, Carcinoma, Renal Cell/pathology, Female, Humans, Kidney Neoplasms/enzymology, Kidney Neoplasms/pathology, Male, Middle Aged, Prognosis, Retrospective Studies, Tumor Markers, Biological/blood, gamma-Glutamyltransferase/blood
Pubmed
Web of science
Open Access
Oui
Création de la notice
20/01/2015 19:35
Dernière modification de la notice
08/05/2019 21:55
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