IDDF2024-ABS-0188 Gamma-glutamyl transferase to aspartate aminotransferase ratio (GSR) predicts prognoses in patients with colorectal cancer with liver metastasis after microwave ablation

<h3>Background</h3> Microwave ablation (MWA) is widely used to eliminate colorectal liver metastases (CRLM). However, the risk of tumor recurrence is difficult to predict due to the lack of reliable clinical and biological markers. Elevation of gamma-glutamyl transferase (GGT) and aspartate transaminase (AST) provides signals for liver inflammation and cancer progression. The present study evaluated the association between pre-ablation GGT to AST ratio index (GSR) and hepatic recurrence in patients with CRLM after MWA. <h3>Methods</h3> A retrospectively analyzed 192 CRLM patients who underwent MWA from January 2013 to January 2017 (IDDF2024-ABS-0188 Figure 1). Pre-ablation GSR was classified into high (≤ 2.34) or low (&gt;2.34) using the upper quartile value. The prognostic value of GSR and other risk factors for liver progression-free survival (LPFS) and cancer-specific survival (CSS) were evaluated by univariate and multivariate analyses. <h3>Results</h3> High GSR was significantly associated with males (<i>P</i> = 0.041), the presence of cholelithiasis (<i>P</i> = 0.012), but not pre-ablation chemotherapy (<i>P</i> = 0.355), which caused significantly increased levels of GGT (<i>P</i> = 0.015) and AST (<i>P</i> = 0.008). GSR showed a significant association with LPFS and CSS through univariate analysis (<i>P</i> = 0.002 and 0.006, IDDF2024-ABS-0188 Figure 2) and multivariate analysis (<i>P</i> = 0.043 and 0.037, IDDF2024-ABS-0188 Figure 3, IDDF2024-ABS-0188 Figure 4). The subgroup analysis demonstrated no interaction between GSR and all variables except for distribution in the sub-analysis of LPFS (IDDF2024-ABS-0188 Figure 5, IDDF2024-ABS-0188 Figure 6). <h3>Conclusions</h3> Measuring GSR in CRLM patients before MWA was a convenient and economical way to predict prognosis.