title: Impact of Diabetes on Outcomes of Sorafenib Therapy for Hepatocellular Carcinoma.
abstract: Patients with diabetes are at increased risk of developing hepatocellular carcinoma (HCC) and have a poorer prognosis as compared to non-diabetics when HCC occurs. Diabetics with non-HCC cancers are at higher risk of toxicity related to systemic therapy, but data on HCC are lacking.
  
  
  
  The aim of this study was to evaluate safety and effectiveness of sorafenib in HCC patients according to the presence/absence of diabetes.
  
  
  
  From October 2008 to June 2014, 313 patients with HCC treated with sorafenib were enrolled. The patients were staged according to the BCLC system. Treatment response was evaluated according to the mRECIST criteria. The main evaluated outcomes were the overall survival and the safety in the two groups.
  
  
  
  Patients were divided in two groups: 80 diabetics (DIAB) and 233 nondiabetics (nDIAB). The median treatment duration was 4 months in DIAB and 3 months in nDIAB. Main adverse events occurred with comparable frequency in both groups, with the exception of rash, that was more frequent among DIAB than in nDIAB: 27.5 % vs 17.6 % (P = .047). The median overall survival was 9 months in nDIAB and 10 months in DIAB group (P = .535). Median time-to-progression (TTP) was longer the in DIAB than the nDIAB group (P = .038).
  
  
  
  Sorafenib was as safe as effective in DIAB and in nDIAB patients. The longer TTP observed among DIAB than in nDIAB patients might suggest a better anticancer effect of sorafenib in patients with diabetes.
authors: Department of Transplantation - Liver Unit, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy. ggdicostanzo@libero.it.
authors: Giovan Giuseppe
authors: GG
authors: Di Costanzo
authors: Department of Transplantation - Liver Unit, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy.
authors: Raffaella
authors: R
authors: Tortora
authors: Department of Clinical Medicine and Surgery - Gastroenterology Unit, University of Naples "Federico II", Naples, Italy.
authors: Filomena
authors: F
authors: Morisco
authors: Department of Transplantation - Liver Unit, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy.
authors: Luigi
authors: L
authors: Addario
authors: Department of Clinical Medicine and Surgery - Gastroenterology Unit, University of Naples "Federico II", Naples, Italy.
authors: Maria
authors: M
authors: Guarino
authors: Department of Transplantation - Liver Unit, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy.
authors: Gabriella
authors: G
authors: Cordone
authors: Department of Transplantation - Liver Unit, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy.
authors: Luigia
authors: L
authors: Falco
authors: Department of Clinical Medicine and Surgery - Gastroenterology Unit, University of Naples "Federico II", Naples, Italy.
authors: Nicola
authors: N
authors: Caporaso
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D000077157:Sorafenib; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib