Impact of Diabetes Mellitus on the Prognosis of Patients with Hepatocellular Carcinoma after Curative Hepatectomy

Wang, Yanyan; Huang, Shan; Zhong, Jian‐Hong; Yang, Ke; Guo, Zhe; Liu, Jiaqi; Ma, Liang; Li, Hang; Ou, Bing-Ning; Li, Le‐Qun

doi:10.1371/journal.pone.0113858

Cited by 30 publications

(38 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Wang et al reported a meta-analysis including 21 studies with total 9,767 HCC patients, and showed that DM is an independent predictor for decreased overall survival (HR 1.55; 95% CI 1.27–1.91; p = 0.001) and disease-free survival (HR 2.15; 95% CI 1.75–2.63; p = 0.001). [12] However, subgroup analyses in that study further disclosed that the effect was only seen in patients receiving hepatic resection (HR 1.91; 95% CI 1.21–3.00; p = 0.005), but not in subjects treated with other modalities.…”

Section: Discussionmentioning

confidence: 93%

See 1 more Smart Citation

Prognostic impact of diabetes mellitus on hepatocellular carcinoma: Special emphasis from the BCLC perspective

Liu

Hsu

et al. 2017

PLoS ONE

View full text Add to dashboard Cite

BackgroundDiabetes mellitus (DM) is associated with higher incidence and poorer prognosis of hepatocellular carcinoma (HCC). The influence of DM on patient survival in different HCC stages is not known.MethodsA prospective dataset of 3,182 HCC patients was collected between 2002 and 2014. Patients were divided into three groups according to BCLC stages (BCLC stage 0 and stage A, BCLC stage B, BCLC stage C and stage D). We compared the cumulative survival rate of diabetic and non-diabetic patients in different BCLC groups. The correlation between DM and overall survival was also analyzed by multivariate Cox regression model within each group.ResultsDM is present in 25.2% of all patients. Diabetic patients had lower cumulative survival in BCLC stage 0 plus BCLC stage A group (log rank p<0.001), and BCLC stage B group (log rank p = 0.012), but not in BCLC stage C plus BCLC stage D group (log rank p = 0.132). Statistically significant differences in overall survival are found between diabetic and non-diabetic patients in BCLC stage 0 plus stage A group (adjusted hazard ratio [HR] = 1.45, 95% confidence interval [CI] 1.08–1.93, p = 0.013), and BCLC stage B (adjusted HR = 1.77, 95% CI 1.24–2.51, p = 0.002). In contrast, the survival difference is not seen in BCLC stage C plus stage D group (adjusted HR = 1.09, 95% CI 0.90–1.30, p = 0.387).ConclusionsDM is prevalent in HCC, and is associated with lower survival rate in HCC patients with BCLC stage 0 plus stage A and B, but not in those with BCLC stage C plus stage D.

show abstract

Section: Discussionmentioning

confidence: 93%

“…[11, 12] Previous studies analyzing the relation between DM and HCC outcomes focused mainly on resectable or potentially curable diseases. However, the results were inconsistent.…”

Section: Introductionmentioning

confidence: 99%

Prognostic impact of diabetes mellitus on hepatocellular carcinoma: Special emphasis from the BCLC perspective

Liu

Hsu

et al. 2017

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…It is also reported that history of diabetes is associated with deaths from HCC [13]. Patients with DM showed significantly lower overall survival than those without DM [14, 15]. Thus, a specific group of people with HCC and T2DM should be observed.…”

Section: Discussionmentioning

confidence: 99%

HbA1c-Based Score Model for Predicting Death Risk in Patients with Hepatocellular Carcinoma and Type 2 Diabetes Mellitus

Shuan

Liu

et al. 2017

Journal of Diabetes Research

View full text Add to dashboard Cite

Aim. To establish a new score model to predict risk of death in patients with hepatocellular carcinoma and type 2 diabetes mellitus. Methods. This was a retrospective study of 147 patients with hepatocellular carcinoma and type 2 diabetes mellitus who came to Beijing Ditan Hospital between October 2008 and June 2013. Univariate and multivariate logistic regression analysis was performed to obtain the independent factors associated with death risk. A new score model was devised according to these factors. Results. A prediction score model composed of HbA1c, NLR, age, and CTP class was devised, which ranged from 0 to 7. AUROC of the score was 0.853 (P < 0.001, 95% CI: 0.791–0.915). Scores 0–2, 3-4, and 5–7 identified patients as low-, medium-, and high-risk categories. The cumulative survival rate was 93.6%, 83.0%, and 74.5% in the low-risk group in 1, 2, and 3 years, while it was 64.0%, 46.0%, and 26.0% in the medium-risk group, whereas it was 24.0%, 12.0%, and 6.0% in the high-risk group, respectively. The cumulative survival rate was significantly higher in the low-risk group than that in the medium-risk group and high-risk group (P < 0.001). Conclusion. The HbA1c-based score model can be used to predict death risk in patients with hepatocellular carcinoma and type 2 diabetes mellitus.

show abstract

“…[31] Although our recent studies suggest that tumor size ≥10 cm (originally referred to as “huge HCC”) [17] is a risk factor of poor OS after HR, [14,15,23,32,33] earlier work reported the same result for tumors ≥7 [34] or ≥8 cm. [35] In the present study, Cox proportional hazard analysis identified a single-tumor >8 cm as a risk factor of poor OS.…”

Section: Discussionmentioning

confidence: 98%

Optimizing stage of single large hepatocellular carcinoma

et al. 2017

Self Cite

View full text Add to dashboard Cite

This study aims to refine the designation for single hepatocellular carcinoma (HCC) >5 cm by comparing the postresection prognosis of these patients with those who have a single-tumor ≤5 cm and those with stage B.Patients with a single-tumor were classified into subgroups based on diameter. Of the 1132 patients analyzed, 426 had a single-tumor >2 and ≤5 cm; 229, a single-tumor >5 and ≤8 cm; 52, a single-tumor >8 and < 10 cm; 150, a single-tumor ≥10 cm; and 275, stage B.Hospital mortality and complications increased with tumor size among the single-tumor subgroups and median survival decreased with increasing of tumor size. Overall survival (OS) among patients with a single-tumor >5 cm was significantly lower than among patients with a single-tumor >2 and ≤5 cm (P ≤ .001), but significantly higher than among patients with clearly stage B (P ≤ .001). Patients with a single-tumor >5 and ≤8 cm showed lower OS than patients with a single-tumor >2 and ≤5 cm (P < .001). Patients with a single-tumor >8 and <10 cm or a single-tumor ≥10 cm showed lower OS than patients with a single-tumor >5 and ≤8 cm (P = .033 and .006), and similar OS to patients with stage B (P = .323).Patients with a single-tumor >5 and ≤8 cm may be assigned to a new stage between early and intermediate. Patients with a single-tumor >8 cm may be assigned to intermediate stage.

show abstract

Impact of Diabetes Mellitus on the Prognosis of Patients with Hepatocellular Carcinoma after Curative Hepatectomy

Cited by 30 publications

References 47 publications

Prognostic impact of diabetes mellitus on hepatocellular carcinoma: Special emphasis from the BCLC perspective

Prognostic impact of diabetes mellitus on hepatocellular carcinoma: Special emphasis from the BCLC perspective

HbA1c-Based Score Model for Predicting Death Risk in Patients with Hepatocellular Carcinoma and Type 2 Diabetes Mellitus

Optimizing stage of single large hepatocellular carcinoma

Contact Info

Product

Resources

About