Diabetes mellitus increases the risk of intrahepatic recurrence of hepatocellular carcinoma after surgical resection


Aims and background

The relationship between cancer and metabolism has recently been receiving attention. We investigated the prognostic influence of type 2 diabetes mellitus in patients with hepatocellular carcinoma (HCC) treated with curative resection.

Methods and study design

The records of 58 patients who underwent curative resection for HCC pT1-2N0M0 between 2010 and 2014 were reviewed retrospectively. Fourteen patients (24.1%) had diabetes mellitus at diagnosis. Local control (LC) was defined as time to recurrence in the liver.


The median follow-up was 23.3 months. Relapses occurred in 20 patients (34.5%) during the follow-up period; 17 of them developed intrahepatic recurrence, which was associated with diabetes mellitus (p = 0.013) and alpha fetoprotein (AFP) levels >500 ng/mL (p = 0.019). Overall relapses (n = 20) were related to T stage (p = 0.044), AFP level (p = 0.005), and diabetes (p = 0.044). The 3-year local control (intrahepatic control), disease-free survival, and overall survival rates were 56.7%, 50.5%, and 84.3%, respectively. LC was affected by diabetes mellitus (p = 0.046), Barcelona Clinic Liver Cancer staging (p<0.001), Milan criteria for transplantation (p = 0.041), serosal invasion (p = 0.032), and microvascular invasion (p = 0.043). Diabetes was also associated with reduced LC in the subgroup with hepatitis B-related HCC (n = 44, p = 0.028).


Diabetes mellitus is correlated with intrahepatic HCC recurrence after surgery. Greater attention should be paid to managing patients with HCC and diabetes mellitus.

Tumori 2017; 103(3): 279 - 285




Yunseon Choi, YoungKil Choi, Chang Soo Choi, Yun-Han Lee

Article History


Financial support: None.
Conflict of interest: The authors have no conflict of interest to disclose.

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  • Department of Radiation Oncology, Inje University School of Medicine, Busan Paik Hospital, Busan - Korea
  • Department of General Surgery, Inje University School of Medicine, Busan Paik Hospital, Busan - Korea
  • Department of Molecular Medicine, College of Medicine, Keimyung University, Daegu - Korea

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