Type 2 diabetes mellitus worsens the prognosis of intermediate-stage hepatocellular carcinoma after transarterial chemoembolization. (November 2020)

• Record Type: Journal Article
• Authors: Liu, Guanghua; Xia, Fang; Fan, Guoping; Yu, Juming; Bao, Lei; Zhang, Caiyuan; Chi, Runmin; Zhang, Tingting; Wang, Lijun; Shen, Feng; Wang, Dengbin
• Is Part Of: Diabetes research and clinical practice. Volume 169(2020)
• Publication Date: 2020-11
• Subjects: Hepatocellular carcinoma -- Transarterial chemoembolization -- Type 2 diabetes mellitus -- Propensity score matching -- Competing risk model -- Prognosis; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2020.108375
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Aims: The aim of this study was to investigate the impact of type 2 diabetes mellitus (T2DM) on the prognosis of hepatocellular carcinoma (HCC) patients following transarterial chemoembolization (TACE). Methods: Time to progression (TTP) and cancer-specific mortality (CSM) in competing risk model were compared in patients with (n = 289) or without (n = 763) T2DM. Propensity score matching (PSM) was used to reduce bias between the two groups. Multivariate competing risk regression was used to evaluate independent risk factors for TTP and CSM. Results: The T2DM group showed significantly worse 5-year TTP and CSM rates than the non-T2DM group both in the whole cohort (n = 1052) and the PSM cohort (n = 514) (81.3% vs. 70.9%, P < 0.001, and 61.5% vs. 49.3%, P = 0.006; 81.4% vs. 68.6%, P = 0.003, and 61.7% vs. 43.2%, P = 0.014, respectively). Multivariate competing risk regression identified T2DM as an independent risk factor for TTP and CSM before and after PSM (hazard ratio: 1.37 [95% confidence interval: 1.07–1.77] and 1.36 [1.05–1.75]; 1.29 [1.04–1.60] and 1.24 [1.02–1.52], respectively). T2DM worsened the long-term outcomes of patients in the cirrhosis subgroup but not those in the noncirrhosis subgroup. Conclusions: T2DM worsened the long-term survival of intermediate-stage HCC patients who underwent TACE, especially in patients with cirrhosis.