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      Serum Inflammation Parameters and Survival in Hepatocellular Carcinoma Patients: Importance of Albumin and Gamma-Glutamyltranspeptidase

      research-article
      a , b
      Oncology
      S. Karger AG
      Hepatocellular carcinoma, Survival, GGT, Albumin, Erythrocyte sedimentation rate

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          Abstract

          Introduction: Many single and combination blood tests that reflect local or systemic inflammation have been shown to be useful prognosticators in patients with a variety of tumor types. To try to clarify, this issue in patients with nonsurgically treatable hepatocellular carcinoma, multiple serum parameters were evaluated for their relationship to survival. Methods: A prospectively collected database was interrogated of 487 patients with known hepatocellular carcinoma and documented survival and having all the inflammation parameters of interest in this study, together with baseline tumor characteristics from CT scans. Serum parameters included NLR, PLR, CRP, ESR, albumin, and GGT. Results: All the parameters had significant hazard ratios on Cox regression model. Combination double parameters with hazard ratios >2.0 were: ESR plus GGT, albumin plus GGT, albumin plus ESR. The triplet combination of albumin plus GGT plus ESR had a hazard ratio of 6.33. Using Harrell’s concordance index (C-index), the highest inflammation-based 2-parameter prognostic score was for albumin plus GGT. When clinical characteristics of patients with high values for albumin plus low values for GGT were compared to low values for albumin plus high values for GGT (worse prognosis), statistically significant differences were found for tumor size, tumor focality, macroscopic portal vein invasion, and serum alpha-fetoprotein levels. Addition of ESR did not provide additional tumor information. Conclusion: The combination of serum albumin plus GGT levels was the most prognostically useful among the inflammation parameters that were tested, and reflected significant differences in tumor aggressiveness characteristics.

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          Author and article information

          Journal
          OCL
          Oncology
          10.1159/issn.0030-2414
          Oncology
          Oncology
          S. Karger AG
          0030-2414
          1423-0232
          2023
          May 2023
          06 March 2023
          : 101
          : 5
          : 313-320
          Affiliations
          [_a] aLiver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
          [_b] bNational Institute of Gastroenterology, S. de Bellis Research Hospital, Bari, Italy
          Author information
          https://orcid.org/0000-0002-6111-5077
          https://orcid.org/0000-0001-7827-1909
          Article
          527650 Oncology 2023;101:313–320
          10.1159/000527650
          36878197
          e792b345-0ad0-4ba5-90f2-4cd483166685
          © 2023 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.

          History
          : 22 August 2022
          : 10 October 2022
          Page count
          Figures: 1, Tables: 6, Pages: 8
          Funding
          This work was supported in part by NIH Grant CA 82723 (B.I.C).
          Categories
          Clinical Study

          Medicine
          Albumin,Hepatocellular carcinoma,Survival,GGT,Erythrocyte sedimentation rate
          Medicine
          Albumin, Hepatocellular carcinoma, Survival, GGT, Erythrocyte sedimentation rate

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