Prognostic significance of gamma-glutamyltransferase in patients with endometrial cancer: a multi-centre trial.
BACKGROUND
Gamma-glutamyltransferase (GTT), a known marker for apoptotic balance, seems to promote tumour progression, invasion and drug resistance. Recently, high GGT serum levels were shown to be associated with impaired prognosis in patients with cervical cancer. The aim of this study was to investigate the value of pre-therapeutic serum GGT levels as prognostic parameter in patients with endometrial cancer.


METHODS
Within the present multi-centre trial, clinical-pathological parameters and pre-therapeutic serum GGT levels were evaluated in 874 consecutive patients with endometrial cancer. Patients were stratified in GGT risk groups, and univariate and multivariable survival analyses were performed.


RESULTS
Mean pre-therapeutic serum GGT level was 30.8 (41.5) U l(-1). Elevated and highly elevated serum GGT levels (P=0.03 and P=0.005), tumour stage (P<0.001 and P<0.001), grade (P<0.001 and P=0.02) and age (P<0.001 and P<0.001) were independently associated with progression-free survival in univariate and multivariable survival analyses. Pre-therapeutic GGT was not associated with advanced tumour stage (P=0.6), higher histological grade (P=0.6) or unfavourable histological subtype (P=0.3).


CONCLUSIONS
Pre-therapeutic serum GGT is a novel and independent prognostic parameter for progression-free survival of patients with endometrial cancer. Stratifying patients into prognostic subgroups could be used for patient counselling and individualised treatment planning.
Department of Gynaecology and Gynaecological Oncology, Comprehensive Cancer Centre Vienna, Medical University of Vienna, Austria.
V
V
Seebacher
S
S
Polterauer
C
C
Grimm
J
J
Rahhal
G
G
Hofstetter
E-M
EM
Bauer
H
H
Husslein
H
H
Leipold
C
C
Marth
A
A
Reinthaller
N
N
Concin
D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D016889:Endometrial Neoplasms / Q000097:blood* / Q000201:enzymology* / Q000401:mortality; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000201:enzymology* / Q000401:mortality; D011379:Prognosis; D015996:Survival Rate; D005723:gamma-Glutamyltransferase / Q000097:blood*
D014408:Biomarkers, Tumor; D005723:gamma-Glutamyltransferase