Prognostic relevance of pretherapeutic gamma-glutamyltransferase in patients with primary metastatic breast cancer.
BACKGROUND
Gamma-glutamyltransferase (GGT) is a known marker for apoptotic balance and cell detoxification. Recently, an association of baseline GGT levels and breast cancer incidence, tumor progression and chemotherapy resistance was shown. The purpose of this study was to evaluate the association of pre-therapeutic GGT levels, clinical-pathological parameters and survival in patients with primary metastatic breast cancer (PMBC).


METHODS
In this multicenter analysis, pre-therapeutic GGT levels and clinical-pathological parameters of 114 patients diagnosed with PMBC between 1996 and 2012 were evaluated. The association between GGT levels and clinical-pathological parameters were analysed. Patients were stratified into four GGT risk-groups (GGT < 18.00 U/L: normal low, 18.00 to 35.99 U/L: normal high, 36.00 to 71.99 U/L: elevated and ≥ 72.00 U/L: highly elevated) and survival analyses were performed.


RESULTS
Patients in the high risk GGT group had a poorer overall survival, when compared to the low risk group with five-year overall survival rates of 39.5% and 53.7% (p = 0.04), respectively. Patients with larger breast tumors had a trend towards higher GGT levels (p = 0.053). Pre-therapeutic GGT levels were not associated with indicators of aggressive tumor biology such as HER2-status, triple negative histology, or poorly differentiated cancers.


CONCLUSIONS
Pre-therapeutic GGT serum level might serve as a novel prognostic factor for overall-survival in patients with PMBC.
Department of General Gynecology and Gynecologic Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Christine
C
Staudigl
Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.
Nicole
N
Concin
Department of General Gynecology and Gynecologic Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Christoph
C
Grimm
Department of General Gynecology and Gynecologic Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Georg
G
Pfeiler
Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.
Regina
R
Nehoda
Department of General Gynecology and Gynecologic Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Christian F
CF
Singer
Department of General Gynecology and Gynecologic Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Stephan
S
Polterauer
D000368:Aged; D015415:Biomarkers / Q000097:blood; D001943:Breast Neoplasms / Q000473:pathology*; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D005723:gamma-Glutamyltransferase / Q000097:blood*
D015415:Biomarkers; D005723:gamma-Glutamyltransferase