Concurrent hyperglycemia does not influence the long-term prognosis of unresectable hepatocellular carcinomas.
OBJECTIVE
The association has been established between the disorder of carbohydrate metabolism and liver cancer. However, little is known regarding the impact of concurrent hyperglycemia on prognosis of hepatocellular carcinoma (HCC). The present study aimed at solving this problem.


METHODS
A total of 225 patients included in this study, were admitted from January 1998 to December 2001 for an unresectable HCC proven by histological and imaging examinations. Most of the patients received interventional treatment, radiation and biotherapy. Response was evaluated by computerized tomography (CT) scan conducted 4-6 weeks following completion of the treatment, and then every 3 months. Survival was calculated from the beginning of treatment using the Kaplan-Meier method. Pretreatment, treatment and follow-up variables with possible prognostic significance were analyzed. A stepwise multivariate analysis was performed using the Cox regression model, and a prognostic index was obtained.


RESULTS
No differences were observed in survival parameters between the patients with and without hyperglycemia, median survival times of the patients were being 26+/-3.46 months and 29.5+/-2.04 months, respectively, and the 3-year survival rate was 8.36 % and 9.62 %, respectively. The univariate analysis indicated that there were several survival-associated variables including serum AFP level, clinical stage, Child-Pugh grade, method of treatment, size and number of tumor nodule (s). However, only the clinical stage, Child-Pugh grade and the treatment procedure were proved to be independent prognostic factors in the multivariate analysis.


CONCLUSIONS
This study indicates that hyperglycemia does not influence the long-term prognosis of HCC, and concurrent hyperglycemia should not be considered as an unfavorable prognostic factor during the treatment of patients with HCC.
Li
Xiao-Ping
XP
Department of Liver Neoplasms, Cancer Hospital, Fudan University, Shanghai 200032, China. lxpmy@sohu.com
Chen
Zhen
Z
Meng
Zhi-Qiang
ZQ
Huang
Wen-Xia
WX
Liu
Lu-Ming
LM
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D013997:Time Factors; D014057:Tomography, X-Ray Computed