Liver transplant for large hepatocellular carcinoma in Malatya: The role of gamma glutamyl transferase and alpha-fetoprotein, a retrospective cohort study

Table 1 Demographics of 50 patients with maximum dominant tumor diameter > 6 cm

Parameter	Median	Min-Max
Age (yr)	56	8-72
MELD score	10	6-28
AFP (ng/mL)	24.5	0.8-12863
Platelets (103/uL)	112	16-528
NLR	2.75	0.3-13.3
PLR	97.1	25.7-302.9
Albumin (g/dL)	3	1.9-4.2
Total bilirubin (mg/dL)	1.58	0.23-13.9
GGT (IU/L)	111.5	17-1396
AST (IU/L)	76.5	19-566
ALT (IU/L)	50	10-657
MTD (cm)	8.5	6.4-24
Number of nodules	2	1-20

AFP: Alpha-fetoprotein; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; GGT: Gamma glutamyl transpeptidase; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; MTD: Maximum dominant tumor diameter.

Table 2 Demographics of 50 patients with maximum dominant tumor diameter > 6 cm

Parameter	n	%
Gender, male	41	82
Child-Pugh score
A	19	38
B	26	52
C	5	10
Etiology
Viral hepatitis	40	80
Cryptogenic	7	14
Fibrolamellar-HCC	1	2
Budd-Chiari	1	2
Ethanol	1	2
Differentiation
Well	16	32
Moderate	26	52
Poor	8	16
Microvascular invasion negative	15	30
Microvascular invasion positive	35	70
TACE/TARE/RFA (+)	8	16

HCC: Hepatocellular carcinoma; TACE: Transarterial chemoembolization; TARE: Transarterial radioembolization; RFA: Radiofrequency ablation.

Table 3 Clinical characteristics of 50 hepatocellular carcinoma patients, maximum dominant tumor diameter > 6 cm, according to serum gamma glutamyl transpeptidase or alpha-fetoprotein levels

Parameters	Low GGT ≤ 104, n = 20, median (min-max)	High GGT > 104, n = 28, median (min-max)	P value	Low AFP ≤ 200, n = 36, median (min-max)	High AFP > 200, n = 14, median (min-max)	P value
AFP (ng/mL)	20.1 (0.8-6388)	45.7 (1.9-12863)	0.818
GGT (IU/L)				114 (17-1396)	106 (29-393)	0.862
AST (IU/L)	76.5 (19-566)	71 (25-313)	0.544	81 (19-566)	76 (28-245)	0.596
Total Bilirubin (mg/dl)	1.7 (0.23-13.9)	1.7 (0.38-13.9)	0.660	1.78 (0.23-13.9)	1.13 (0.38-11.7)	0.270
MTD (cm)	8.5 (6.5-22)	8.5 (6.4-24)	0.992	8.5 (6.4-24)	8.5 (6.5-22)	0.896
Microvascular invasion, n (%)			0.04a			0.360
Negative	9 (45)	5 (18)		11 (31)	4 (29)
Positive	11 (55)	23 (82)		25 (69)	10 (71)
Differentiation, n (%)
Well	11 (55)	4 (15)	0.011a	13 (36)	3 (21)	0.324
Moderate	7 (35)	18 (64)		19 (53)	7 (50)
Poor	2 (10)	6 (21)		4 (11)	4 (29)
Number of nodules
1	10 (50)	12 (43)	0.845	16 (44)	6 (43)	1.000
> 1	10 (50)	16 (57)		20 (56)	8 (57)

^aP < 0.05.

AFP: Alpha-fetoprotein; GGT: Gamma glutamyl transpeptidase; AST: Aspartate aminotransferase; MTD: Maximum dominant tumor diameter.

Table 4 Clinical characteristics of combination low alpha-fetoprotein/gamma glutamyl transpeptidase patients vs all other combinations

Parameters	Low AFP ≤ 200, low GGT ≤ 104, n = 14	Other combos, n = 34	P value
AFP (ng/mL)
Median	7.35	132.5	0.009b
mean ± SD	21.6 ± 32.4	758.5 ± 2397.2
GGT (IU/L)
Median	63	140.5	< 0.001c
mean ± SD	59.6 ± 31.6	208.9 ± 232.4
Total Bilirubin (mg/dL)
Median	2	1.4	0.511
mean ± SD	3.2 ± 3.8	2.5 ± 3.0
AST (IU/L)
Median	68.5	77.5	0.892
mean ± SD	126.2 ± 145.9	93.2 ± 66.4
MTD (cm)
Median	8.75	8.25	0.317
mean ± SD	8.66 ± 1.18	9.9 ± 4.5
Number of nodules, n (%)
1	8 (57)	14 (41)	0.490
> 1	6 (43)	20 (59)
Microvascular invasion, n (%)
Negative	7 (50)	7 (21)	0.041a
Positive	7 (50)	27 (79)
Differentiation, n (%)
Well	7 (50)	7 (20)	0.020a
Moderate	5 (36)	19 (56)
Poor	2 (14)	8 (24)

^aP < 0.05.

^bP < 0.01.

^cP < 0.001.

AFP: Alpha-fetoprotein; GGT: Gamma glutamyl transpeptidase; AST: Aspartate aminotransferase; MTD: Maximum dominant tumor diameter; SD: Standard deviation.