The influence of postoperative glycemic control on recurrence after curative resection in diabetics with hepatitis C virus-related hepatocellular carcinoma

Background and Objectives To elucidate the influence of diabetes on tumor recurrence after curative resection for hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC). Methods: A total of 100 patients who underwent curative resection for solitary HCV-related HCC were analyzed. Data from 26 patients with diabetes were compared to those of 74 patients without diabetes. The two groups were matched in terms of presence of cirrhosis, Child-Pugh classification, and tumor size (within 10%). Results: Tumor-free survival rates were 45% and 48% at 3 years and 27% and 27% at 5 years in patients with and without diabetes, respectively. No significant difference was observed in the tumor-free survival rates between patients with and without diabetes. Tumor-free survival rates were 66% and 27% at 3 years in patients with normal postoperative glycated hemoglobin (HbA1c) level (HbA1c, < 6.5%) and elevated postoperative HbA1c level (HbA1c, 6.5%), respectively. Multivariate analysis showed that poor glycemic control (HbA1c, 6.5%) was associated with postoperative tumor recurrence in patients with diabetes [ odds ratio (OR) 3.551, 95% confidence interval (CI) 1.129-11.172, P 0.030]. Conclusions: Careful control of plasma glucose should be performed to prevent tumor recurrence after curative resection for HCV-related HCC in patients with diabetes. J. Surg. Oncol. 2012; 105: 606-611. (C) 2011 Wiley Periodicals, Inc.