MP88-01 THE PROGNOSTIC VALUE OF PRE-CYSTECTOMY SERUM G-GLUTAMYLTRANSFERASE LEVELS IN PATIENTS WITH INVASIVE BLADDER CANCER
2017-04-01

You have accessJournal of UrologyBladder Cancer: Basic Research & Pathophysiology IV1 Apr 2017MP88-01 THE PROGNOSTIC VALUE OF PRE-CYSTECTOMY SERUM G-GLUTAMYLTRANSFERASE LEVELS IN PATIENTS WITH INVASIVE BLADDER CANCER Tina Schubert, Manuel Alexander Schmid, Thomas Lütfrenk, Markus Renninger, Arnulf Stenzl, and Georgios Gakis Tina SchubertTina Schubert More articles by this author , Manuel Alexander SchmidManuel Alexander Schmid More articles by this author , Thomas LütfrenkThomas Lütfrenk More articles by this author , Markus RenningerMarkus Renninger More articles by this author , Arnulf StenzlArnulf Stenzl More articles by this author , and Georgios GakisGeorgios Gakis More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2726AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prior experimental studies have shown that the enzyme γ-glutamyltransferase (γ-GT) is overexpressed during carcinogenetic transformation of urothelial cells. This analysis aimed to elucidate the prognostic value of serum γ-GT, glutamat-pyruvat-transaminase (GPT) and glutamat-oxalat-transaminase (GOT) levels in patients with invasive bladder cancer (BC). METHODS Preoperative serum γ-GT, GPT and GOT concentrations were assessed in 324 patients treated with RC for clinically non-metastatic BC between 2002 and 2013. Laboratory values were obtained 1-3 days prior to RC. Uni- and multivariable analyses were carried out to evaluate clinicopathologic features and survival after RC. The median follow-up was 36 months (IQR: 10-55). RESULTS Elevated preoperative γ-GT, GPT and GOT levels were diagnosed in 77 (23.8%), 20 (6.2%) and 18 (5.5%) patients, respectively. Elevated γ-GT levels were significantly associated with advanced tumor stage (≥pT3a; p=0.001), lymph-node tumor involvement (p<0.001), positive surgical margins (p=0.018), lymphovascular invasion (p=0.024), muscle-invasive disease at primary diagnosis (p=0.033), increased tumor size (continuously coded; p=0.035), receipt of neoadjuvant chemotherapy (p=0.006), higher Eastern Cooperative Performance Status (p=0.001), hydronephrosis at RC (p=0.049), increased preoperative serum C-reactive protein levels (p<0.001) and elevated serum GPT and GOT levels (both p<0.001). Patients with elevated γ-GT concentration exhibited inferior 3-year disease-free (52.5% vs. 63.2%; p=0.19), cancer-specific (71.1% vs. 80.9%; p=0.042) and overall survival rates (49.2% vs. 69.6%; p=0.005) compared to patients with normal levels. On multivariable analysis, higher ECOG performance status, hydronephrosis at RC (both p=0.010), positive surgical margin status (p=0.014), lymph node positive disease (p=0.030), advanced tumor stage (p=0.032), and an elevated γ-GT concentration (p=0.043) were independent predictors of all-cause mortality. CONCLUSIONS Elevated preoperative γ-GT levels are associated with a significantly increased risk for locally advanced bladder cancer and mortality. These data suggest that γ-GT levels may be a useful prognostic marker for patients after RC for BC. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1174 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Tina Schubert More articles by this author Manuel Alexander Schmid More articles by this author Thomas Lütfrenk More articles by this author Markus Renninger More articles by this author Arnulf Stenzl More articles by this author Georgios Gakis More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...