Impact of Diabetes on Recurrence of Hepatocellular Carcinoma after Surgical Treatment in Patients With Viral Hepatitis

• Published in: The American journal of gastroenterology Vol. 102; no. 9; pp. 1939 - 1946
• Main Authors: KOMURA, Takuya, MIZUKOSHI, Eishiro, HONDA, Masao, TAKAMURA, Toshinari, KANEKO, Shuichi, KITA, Yuki, SAKURAI, Masaru, TAKATA, Yoshiko, ARAI, Kuniaki, YAMASHITA, Tatsuya, OHTA, Tetsuo, SHIMIZU, Koichi, NAKAMOTO, Yasunari
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing 01-09-2007; Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
• Subjects: Biological and medical sciences; Carcinoma, Hepatocellular - complications; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - virology; Diabetes Complications; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Hepatectomy; Hepatitis C virus; Hepatitis, Viral, Human - complications; Human viral diseases; Humans; Infectious diseases; Liver Neoplasms - complications; Liver Neoplasms - mortality; Liver Neoplasms - virology; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Neoplasm Metastasis; Survival Analysis; Survival Rate; Tumors; Viral diseases; Viral hepatitis; Endocrinopathy; Human; Postoperative; Relapse; Prognosis; Diabetes mellitus; Hepatic disease; Hepatocellular carcinoma; Malignant tumor; Survival; Virus; Infection; Viral hepatitis; Treatment; Viral disease; Surgery; Digestive diseases; Flaviviridae; Hepatitis C virus; Hepacivirus; Child
• ISSN: 0002-9270; 1572-0241
• DOI: 10.1111/j.1572-0241.2007.01354.x

Consensus has been reached that diabetes is a risk factor for development of HCC, but the impact on postoperative recurrence is still controversial. To clarify this point, we analyzed the relationship of postoperative recurrence rate of HCC and coexistence of diabetes in the patients with viral hepatitis.
A total of 90 patients who had undergone curative resection for HCC were analyzed. They were divided into two groups with and without diabetes, and the recurrence-free survival rates after surgical treatment and the factors contributing to recurrence were examined.
Kaplan-Meier survival analysis showed the recurrence-free survival rates in the diabetic group were significantly lower than those in the nondiabetic group (P= 0.005) and overall survival rates in the diabetic group were significantly lower than those in the nondiabetic group (P= 0.005). These results were emphasized in the analysis of patients infected with hepatitis C virus. Univariate and multivariate analyses showed diabetes was a significant factor contributing to HCC recurrence after treatment. Furthermore, multivariate analysis in HCC patients with diabetes showed Child-Pugh classification B (P= 0.001) and insulin therapy (P= 0.049) were significant factors contributing to HCC recurrence after treatment.
The results of the present study suggest that diabetes is a risk factor for the recurrence of HCV-related HCC and decreases the overall survival rates after surgical treatment. HCV-related HCC patients with diabetes should be closely followed for postoperative recurrence.