Prognostic impact of diabetes mellitus on patients with hepatocellular carcinoma after curative resection
10.3760/cma.j.issn.1007-631X.2014.09.009
- VernacularTitle:糖尿病对肝细胞癌切除术后患者预后的影响
- Author:
Yanyan WANG
;
Shan HUANG
;
Jianhong ZHONG
;
Yang KE
;
Liang MA
;
Xuemei YOU
;
Lequn LI
- Publication Type:Journal Article
- Keywords:
Carcinoma,hepatocellular;
Diabetes mellitus;
Propensity score;
Prognosis
- From:
Chinese Journal of General Surgery
2014;29(9):688-692
- CountryChina
- Language:Chinese
-
Abstract:
Objective To retrospectively assess the prognostic impact of diabetes mellitus (DM) on patients with hepatocellular carcinoma (HCC) after curative resection.Methods A total of 417 HCC patients who had undergone curative hepatic resection were included into two groups.108 patients were classified into DM group and 309 patients into the non-DM group.Overall survival,disease-free survival,postoperative morbidity and mortality were compared between the two groups after reducing confounding bias by propensity score matching.Independent prognostic predictors were determined by Cox proportional hazards model.Results Propensity score matching resulted in 89 patients in each group,and variables were balanced between two groups.In the matched cohort,DM and non-DM groups showed similar morbidity and 30-and 90-day mortality after curative hepatectomy (respectively x2 =0.837,x2 =Fisher,x2 =Fisher,all P ＞ 0.05),the 1-,3-,and 5-year overall survival rates were 82.0％,59.9％,and 33.4％ in DM group and 90.7％,79.1％,and 69.3％ in non-DM group,respectively(P =0.001),however,there was no significant difference in disease-free survival between DM and non-DM groups.Cox multivariate analysis revealed that DM is an independent risk factor for overall survival in patients with HCC after curative resection,but not for disease-free survival.Conclusions DM does not increase the postoperative morbidity or mortality for patients with HCC after curative resection,however,DM may increase the risk of mortality of HCC patients in the long-term.
