Diabetes Is a Risk Factor for Liver Cancer Recurrence after Surgery in Patients
with Viral Hepatitis
Most
experts agree that diabetes is a risk factor for the initial development of hepatocellular
carcinoma (HCC), a form of liver cancer that can develop in people with chronic
liver disease, including chronic hepatitis B
or C. However, the impact of diabetes on post-operative
HCC recurrence is not clear.
HCC
may be treated using a variety of methods, including chemotherapy, radiation,
and surgery known as hepatic resection (removal of cancerous tumors or heavily affected sections of the liver). However,
HCC often recurs after treatment.
As
reported in the June 15, 2007 advance online edition of the American Journal
of Gastroenterology, Japanese researchers analyzed the relationship between
post-operative HCC recurrence and co-existence of diabetes in the patients with
viral hepatitis.
The
study included 90 patients who had undergone curative resection for HCC. They
were divided into 2 groups -- those with and without diabetes -- and the recurrence-free
survival rates after surgical treatment and factors contributing to recurrence
were assessed. Results
Kaplan-Meier survival
analysis showed that the HCC recurrence-free survival rates in the diabetic group
were significantly lower than those in the non-diabetic group (P = 0.005).
Overall survival rates
in the diabetic group were significantly lower than those in the non-diabetic
group (P = 0.005).
These results were
emphasized in the analysis of patients infected with hepatitis C virus.
Univariate and multivariate analyses
showed diabetes was a significant factor contributing to HCC recurrence after
treatment.
Furthermore, multivariate
analysis in HCC patients with diabetes showed Child-Pugh classification B (P =
0.001) and use of insulin therapy (P = 0.049) were significant factors contributing
to HCC recurrence after treatment.
Conclusions
“The
results of the present study suggest that diabetes is a risk factor for the recurrence
of HCV-related HCC and decreases the overall survival rates after surgical treatment,”
the authors concluded. “HCV-related HCC patients with diabetes should be closely
followed for postoperative recurrence.”
07/13/07
Reference
T Komura,
E Mizukoshi, Y Kita, and others.
Impact of Diabetes on Recurrence of Hepatocellular Carcinoma after Surgical Treatment in Patients
With Viral Hepatitis. American Journal
of Gastroenterology. June 15, 2007 [Epub ahead of print].
