Gamma-glutamyltransferase and the survival of hepatocellular carcinoma patients after transarterial chemoembolization: a meta‑analysis and systematic review.

OBJECTIVE: Plentiful studies have reported that preoperative gamma-glutamyltransferase (GGT) had a strong relationship with the prognosis of hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization (TACE). Nevertheless, due to the small sample size and contradictory conclusions, the predictive function remains indefinite. To investigate the relationship between pretreatment GGT value and clinical outcomes in HCC patients undergoing TACE, a meta-analysis including 10 articles was constructed. METHOD: Studies were searched in PubMed, Embase, Web of Science, Cochrane Library, CNKI, and Wanfang database. Pooled Hazard Ratio (HR) or Odd Ratio (OR) with its 95% confidence intervals was calculated to evaluate the prognostic value of pretreatment GGT in HCC patients undergoing TACE. RESULT: Ten studies with 3274 patients were included in our meta-analysis. The pooled results show that elevated pretreatment GGT has a close relationship to poorer OS (HR 1.72; 95%CI: 1.48-2.01, P < 0.00001, I2 = 56%) after TACE. Additionally, further subgroup analyses suggested that pretreatment GGT was associated with gender (male) (OR 2.02; 95%CI: 1.42-2.88; P < 0.0001), multiple tumours (OR 1.55; 95%CI: 1.18-2.03; P = 0.001), and Child-Pugh class (OR 2.09; 95%CI: 1.44-3.03; P = 0.0001). CONCLUSION: The result of our meta-analysis indicates that pretreatment GGT had a significant relationship with the clinical outcome in HCC patients after TACE and can serve as an useful marker for predicting overall survival. TRIAL REGISTRATION: Prospero number: CRD42024504715.