title: Impact of diabetes on recurrence of hepatocellular carcinoma after surgical treatment in patients with viral hepatitis.
abstract: OBJECTIVE
  Consensus has been reached that diabetes is a risk factor for development of HCC, but the impact on postoperative recurrence is still controversial. To clarify this point, we analyzed the relationship of postoperative recurrence rate of HCC and coexistence of diabetes in the patients with viral hepatitis.
  
  
  METHODS
  A total of 90 patients who had undergone curative resection for HCC were analyzed. They were divided into two groups with and without diabetes, and the recurrence-free survival rates after surgical treatment and the factors contributing to recurrence were examined.
  
  
  RESULTS
  Kaplan-Meier survival analysis showed the recurrence-free survival rates in the diabetic group were significantly lower than those in the nondiabetic group (P= 0.005) and overall survival rates in the diabetic group were significantly lower than those in the nondiabetic 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 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. HCV-related HCC patients with diabetes should be closely followed for postoperative recurrence.
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Komura
authors.forename: Eishiro
authors.initials: E
authors.lastname: Mizukoshi
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kita
authors.forename: Masaru
authors.initials: M
authors.lastname: Sakurai
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Takata
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Arai
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yamashita
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ohta
authors.forename: Koichi
authors.initials: K
authors.lastname: Shimizu
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Nakamoto
authors.forename: Masao
authors.initials: M
authors.lastname: Honda
authors.forename: Toshinari
authors.initials: T
authors.lastname: Takamura
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kaneko
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality / Q000473:pathology* / Q000821:virology; D048909:Diabetes Complications; D005260:Female; D006498:Hepatectomy; D006525:Hepatitis, Viral, Human / Q000150:complications*; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000401:mortality / Q000821:virology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D016019:Survival Analysis; D015996:Survival Rate