The influence of preoperative gamma-glutamyl transferase to albumin ratio on the prognosis of patients with BCLC stage 0-A hepatocellular carcinoma after microwave ablation
10.3760/cma.j.cn113884-20240917-00279
- VernacularTitle:术前γ-谷氨酰转移酶与白蛋白比值对BCLC分期0～A期肝细胞癌患者微波消融术后预后的影响
- Author:
Xiaolin LIU
1
;
Feng XU
;
Fanchuang KONG
;
Yanhua HUANG
;
Chunhui ZHOU
;
Jing CHEN
;
Xiaoguang WANG
Author Information
1. 嘉兴市第二医院肝胆外科，嘉兴 314000
- Publication Type:Journal Article
- Keywords:
Carcinoma, hepatocellular;
Gamma-glutamyl transpeptidase to albumin ratio;
Ablation techniques;
Prognosis
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(1):17-22
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of preoperative gamma-glutamyl transferase to albumin ratio (GAR) on prognosis of patients with Barcelona clinic liver cancer (BCLC)stage 0-A hepatocellular carcinoma (HCC) after microwave ablation (MWA).Methods:The clinical data of 201 patients with BCLC stage 0 to A who underwent MWA at two centers of Jiaxing Second Hospital and Shengjing Hospital of China Medical University from January 2011 to December 2018 were retrospectively analyzed, including 152 males and 49 females, aged (57.5±9.6) years. X-tile software was used to divide patients into a low GAR group ( n=84, GAR<0.9) and a high GAR group ( n=117, GAR≥0.9). Kaplan-Meier method was used for survival analysis, and log-rank test was used for survival comparison. Univariate and multivariate Cox regression analysis was used to evaluate the relationship between GAR and prognosis. Results:The cumulative survival rates at 1, 3 and 5 years postoperatively were 98.7%, 93.8%, 78.5% for the low GAR group, which were superior to that 97.2%, 87.1%, 70.2% for the high GAR group, and the difference was statistically significant ( χ2=11.89, P=0.001). The recurrence-free survival rates at 1, 3 and 5 years after surgery between the two groups was no significant difference ( χ2=1.70, P=0.192). Multivariate analysis revealed that high GAR ( HR=2.723, 95% CI: 1.508-4.914, P=0.001) was independent risk factors for overall survival after MWA in patients with BCLC stages 0 to A HCC. Male gender ( HR=1.959, 95% CI: 1.127-3.305, P=0.017) and tumor diameter ≥2 cm ( HR=1.547, 95% CI: 1.008-2.373, P=0.046) were independent risk factors for recurrence after MWA in patients with BCLC stages 0 to A HCC. Univariate analysis, GAR≥0.9 was not associated with postoperative recurrence ( HR=1.315, 95% CI: 0.869-1.989, P=0.195). Conclusion:Preoperative GAR (≥0.9) is an independent risk factor affecting overall survival in patients with BCLC stages 0 to A HCC after MWA.
