ArticleTherapeutic advances in medical oncology2026
Prognostic value of perioperative gamma-glutamyl transferase trajectories in perihilar cholangiocarcinoma: a multicentre retrospective cohort study.
Article in Therapeutic advances in medical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Perihilar cholangiocarcinoma (pCCA) is a highly aggressive malignancy that persists even after curative resection. Although serum gamma-glutamyl transferase (GGT) is associated with cancer prognosis, most studies have evaluated its prognostic role only at a single time point. However, the prognostic value of perioperative dynamic trajectories remains unclear. Objectives: To evaluate perioperative GGT trajectories as prognostic markers in patients with pCCA undergoing radical resection. Design: This retrospective multicentre study included 765 patients with pCCA who underwent curative resection at two centres. Methods: Perioperative GGT trajectories were modelled using latent class mixed models. Patients were categorised according to trajectory patterns, and associations with overall survival (OS) were evaluated using multivariate Cox regression with clinical covariates. Model discrimination was assessed using time-dependent receiver operating characteristic analysis. Results: Two distinct perioperative GGT trajectories were identified: flat and V-shaped. The model showed an adequate fit (Bayesian Information Criterion (BIC) = 35818.61) and good classification quality (entropy = 0.69). The two classes accounted for 48.32% and 51.68% of the patients, respectively. Patients in the flat trajectory group had significantly longer OS (HR = 0.603, 95% CI: 0.450-0.808, Conclusion: Perioperative GGT trajectories independently predicted pCCA prognosis. Monitoring GGT dynamics may offer a simple and practical tool for postoperative risk stratification.
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