title: Diabetes mellitus not an unfavorable factor on the prognosis of hepatitis C virus-related hepatocellular carcinoma.
abstract: OBJECTIVE
  Diabetes mellitus (DM) is a potential risk factor for hepatocarcinogenesis, especially in patients with hepatitis C virus (HCV) infection. We aimed to elucidate whether DM influences the surgical outcomes of patients with hepatocellular carcinoma (HCC).
  
  
  METHODS
  Our patients were routinely controlled to keep urinary glucose excretion to less than 3.0 g/day before surgery, and the serum glucose level under 200 mg/dL after surgery. The surgical outcomes and postoperative complications of 112 patients with HCV-related HCC with DM (DM group) were compared to those of 112 propensity-matched patients without DM (non-DM group).
  
  
  RESULTS
  After a median follow-up of 3.2 years (range, 0.2-11.3 years), the median overall (5.2 years; 95% confidence interval, 3.8-6.5 years) and recurrence-free survival (2.2 years; 1.7-2.9 years) in the DM group were not significantly different from those (6.3 years; 5.4-7.1 years, P = 0.337; and 2.2 years; 1.7-3.6 years, P = 0.613) in the non-DM group. The independent factors related to overall survival were the background liver (hazard ratio, 2.06; 95% confidence interval, 1.27-3.39, P = 0.014) and tumor differentiation grade (2.07; 1.14-4.05, P = 0.015). Thirty-two patients (28.5%) in the DM group and 32 patients (28.5%) in the non-DM group had morbidities after operation, with no significant difference between the groups (P = 1.000). Furthermore, postoperative control status of DM did not affect the prognostic outcome.
  
  
  CONCLUSIONS
  Diabetes mellitus does not affect the surgical outcomes of patients with HCV-related HCC, and it is not an unfavorable factor when selecting candidates for liver resection of HCC.
authors.affiliation: Departments of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Yoshida
authors.affiliation: Departments of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Midorikawa
authors.affiliation: Departments of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Tokio
authors.initials: T
authors.lastname: Higaki
authors.affiliation: Departments of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Nakayama
authors.affiliation: Genome Science Division, Research Center for Advanced Science and Technologies, The University of Tokyo, Tokyo, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Tsuji
authors.affiliation: Gastroenterology and Hepatology, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Matsuoka
authors.affiliation: Diabetes and Metabolic Diseases, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Hisamitsu
authors.initials: H
authors.lastname: Ishihara
authors.affiliation: Gastroenterology and Hepatology, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Moriyama
authors.affiliation: Departments of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Takayama
keywords: diabetes mellitus; hepatitis C; hepatocellular carcinoma; propensity score