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.
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.
Authors: Hude Quan; Vijaya Sundararajan; Patricia Halfon; Andrew Fong; Bernard Burnand; Jean-Christophe Luthi; L Duncan Saunders; Cynthia A Beck; Thomas E Feasby; William A Ghali Journal: Med Care Date: 2005-11 Impact factor: 2.983
Authors: Manal M Hassan; Steven A Curley; Donghui Li; Ahmed Kaseb; Marta Davila; Eddie K Abdalla; Milind Javle; Dalia M Moghazy; Richard D Lozano; James L Abbruzzese; Jean-Nicolas Vauthey Journal: Cancer Date: 2010-04-15 Impact factor: 6.860
Authors: Bart J Veldt; Wendong Chen; E Jenny Heathcote; Heiner Wedemeyer; Juerg Reichen; W Peter Hofmann; Robert J de Knegt; Stefan Zeuzem; Michael P Manns; Bettina E Hansen; Solko W Schalm; Harry L A Janssen Journal: Hepatology Date: 2008-06 Impact factor: 17.425
Authors: Lorraine L Lipscombe; Pamela J Goodwin; Bernard Zinman; John R McLaughlin; Janet E Hux Journal: Breast Cancer Res Treat Date: 2007-07-21 Impact factor: 4.872
Authors: J Polesel; A Zucchetto; M Montella; L Dal Maso; A Crispo; C La Vecchia; D Serraino; S Franceschi; R Talamini Journal: Ann Oncol Date: 2008-08-22 Impact factor: 32.976
Authors: Valter Donadon; Massimiliano Balbi; Michela Ghersetti; Silvia Grazioli; Antonio Perciaccante; Giovanni Della Valentina; Rita Gardenal; Maria Dal Mas; Pietro Casarin; Giorgio Zanette; Cesare Miranda Journal: World J Gastroenterol Date: 2009-05-28 Impact factor: 5.742