Abstract
Background: The influence of diabetes mellitus (DM) on the prognosis of patients with hepatocellular carcinoma (HCC) remains controversial. Here we investigated the impact of DM on the prognosis of such patients after curative hepatectomy. Methods: A consecutive cohort of 505 patients with HCC (134 with DM, 371 without) underwent curative hepatectomy were retrospectively evaluated. Postoperative morbidity and mortality, overall survival (OS) and disease-free survival (DFS) were compared between patients with or without DM. Independent prognostic predictors were identified using the Cox proportional hazards model. Results: Patients with or without DM showed similar morbidity and 30- and 90- day mortality after curative hepatectomy (all P>0.05), as well as similar DFS at 1, 3, 5 years (P = 0.781). However, the group of patients with DM showed significantly lower OS at 1, 3, 5 years than the group without DM (P = 0.038). Similar results were obtained in the propensity-matched cohort. Cox multivariate analysis identified DM as an independent predictor of poor OS, but not of poor DFS. We repeat compared OS and DFS for DM and non-DM subgroups defined according to the presence or absence of hepatitis B virus infection and cirrhosis. Similar results were obtained in all subgroups except the non-cirrhotic subgroup which showed patients with and without DM had similar OS. Conclusions: DM does not significantly affect the postoperative morbidity or mortality or the DFS of patients with HCC after curative hepatectomy. It is, however, associated with significantly lower OS, especially in patients with cirrhosis.
Highlights
Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide, and its incidence is increasing in many countries [1]
diabetes mellitus (DM) is a common comorbidity in HCC patients, and growing studies indicated that it is associated with increased risk of HCC and other malignancies [13, 31,32,33]
Some authors suggest that DM can significantly worsen prognosis of HCC patients after hepatectomy, while others disagree
Summary
Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide, and its incidence is increasing in many countries [1]. The influence of diabetes mellitus (DM) on the prognosis of patients with hepatocellular carcinoma (HCC) remains controversial. Postoperative morbidity and mortality, overall survival (OS) and disease-free survival (DFS) were compared between patients with or without DM. Results: Patients with or without DM showed similar morbidity and 30- and 90- day mortality after curative hepatectomy (all P.0.05), as well as similar DFS at 1, 3, 5 years (P50.781). Conclusions: DM does not significantly affect the postoperative morbidity or mortality or the DFS of patients with HCC after curative hepatectomy. It is, associated with significantly lower OS, especially in patients with cirrhosis
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