Open AccessDiabetes Mellitus Is Associated with Increased Mortality in Patients Receiving Curative Therapy for Hepatocellular Carcinoma
Author(s) -
Shau WenYi,
Shao YuYun,
Yeh YiChun,
Lin ZhongZhe,
Kuo Raymond,
Hsu ChihHung,
Hsu Chiun,
Cheng AnnLii,
Lai MeiShu
Publication year - 2012
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2012-0065
Subject(s) - medicine , hepatocellular carcinoma , hazard ratio , diabetes mellitus , stage (stratigraphy) , gastroenterology , cirrhosis , liver cancer , population , cancer , multivariate analysis , cancer registry , proportional hazards model , oncology , confidence interval , endocrinology , paleontology , environmental health , biology
Background. Diabetes mellitus (DM) is closely associated with hepatocarcinogenesis. This study explores the prognostic impact of DM in patients who received curative therapy for localized hepatocellular carcinoma (HCC). Methods. Patients who had been diagnosed with stage I or II HCC in 2003 and 2004 and received surgical resection or local ablation therapy were identified from the population‐based Taiwan National Cancer Registry. Data pertaining to DM and other comorbidities were retrieved from the Taiwan National Health Insurance database. Liver cancer‐specific survival (LCS), liver disease‐related survival (LDS) and overall survival (OS) rates were compared between patients with and without DM. The presence of other comorbidities and tumor status were adjusted using multivariate analysis. Results. A total of 931 patients who fulfilled the study criteria were analyzed; 185 (20%) of them had DM (type 1 or type 2). The LCS, LDS, and OS rates were significantly worse for patients with DM than patients without DM (all p < .001). After adjusting for age, sex, tumor stage, treatment, and the presence of other comorbidities, DM remained an independent predictor of poorer LCS (hazard ratio [HR] = 1.57; p < .001), LDS (HR = 1.70; p < .001), and OS (HR = 1.69; p < .001). The associations between DM and mortality were consistent among subgroups, irrespective of tumor size, stage, treatment modality, and liver cirrhosis. Conclusions. DM is an independent factor for poorer prognosis in patients who received curative therapy for localized HCC.