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.
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
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsYunseon Choi, YoungKil Choi, Chang Soo Choi, Yun-Han Lee
- • Accepted on 04/12/2016
- • Available online on 07/01/2017
- • Published in print on 12/05/2017
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- Choi, Yunseon [PubMed] [Google Scholar] 1, * Corresponding Author (firstname.lastname@example.org)
- Choi, YoungKil [PubMed] [Google Scholar] 2
- Choi, Chang Soo [PubMed] [Google Scholar] 2
- Lee, Yun-Han [PubMed] [Google Scholar] 3
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