TY - JOUR
T1 - Diabetes mellitus may affect the long-term survival of hepatitis B virus-related hepatocellular carcinoma patients after liver transplantation
AU - Zhang, Qing
AU - Deng, Yong Lin
AU - Liu, Chang
AU - Huang, Li Hong
AU - Shang, Lei
AU - Chen, Xin Guo
AU - Wang, Le Tian
AU - Du, Jin Zan
AU - Wang, Ying
AU - Wang, Pei Xiao
AU - Zhang, Hui
AU - Shen, Zhong Yang
N1 - Publisher Copyright:
© 2016 Baishideng Publishing Group Inc. All rights reserved.
PY - 2016/11/21
Y1 - 2016/11/21
N2 - AIM: To determine whether diabetes mellitus (DM) affects prognosis/recurrence after liver transplantation (LT) for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). METHODS: A retrospective study was conducted between January 2000 and August 2013 on 1631 patients with HBV-related HCC who underwent LT with antiviral prophylaxis. Patient data were obtained from the China Liver Transplant Registry (https://www.cltr.org/). To compare the outcomes and tumor recurrence in the HBV-related HCC patients with or without DM, statistical analyses were conducted using χ2 tests, Mann-Whitney tests, the Kaplan-Meier method, log-rank tests and multivariate step-wise Cox regression analysis. RESULTS: Univariate analysis of 1631 patients who underwent LT found overall 1-, 3- and 5-year survival rates of 79%, 73% and 71% respectively in the DM patients, and 84%, 78% and 76% in the non-DM patients respectively. Overall survival rate differences after LT between the two groups were significant (p = 0.041), but recurrence-free survival rates were not (p = 0.096). By stratified analysis, the overall survival rates in DM patients for age > 50 years (p = 0.002), the presence of vascular invasion (p = 0.096), tumors ≤ 3 cm (p = 0.047), two to three tumor nodules (p = 0.007), Child-Pugh grade B (p = 0.018), and pre-LT alanine aminotransferase levels between 40 and 80 IU/L (p = 0.017) were significantly lower than in non-DM patients. Additionally, serum α-fetoprotein level > 2000 ng/ml (p = 0.052) was associated with a significant survival difference trend between DM and non-DM patients. Multivariate analysis showed that the presence of DM (p < 0.001, HR = 1.591; 95%CI: 1.239-2.041) was an independent predictor associated with poor survival after LT. CONCLUSION: HBV-related HCC patients with DM have decreased long-term overall survival and poor LT outcomes. Prevention strategies for HCC patients with DM are recommended.
AB - AIM: To determine whether diabetes mellitus (DM) affects prognosis/recurrence after liver transplantation (LT) for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). METHODS: A retrospective study was conducted between January 2000 and August 2013 on 1631 patients with HBV-related HCC who underwent LT with antiviral prophylaxis. Patient data were obtained from the China Liver Transplant Registry (https://www.cltr.org/). To compare the outcomes and tumor recurrence in the HBV-related HCC patients with or without DM, statistical analyses were conducted using χ2 tests, Mann-Whitney tests, the Kaplan-Meier method, log-rank tests and multivariate step-wise Cox regression analysis. RESULTS: Univariate analysis of 1631 patients who underwent LT found overall 1-, 3- and 5-year survival rates of 79%, 73% and 71% respectively in the DM patients, and 84%, 78% and 76% in the non-DM patients respectively. Overall survival rate differences after LT between the two groups were significant (p = 0.041), but recurrence-free survival rates were not (p = 0.096). By stratified analysis, the overall survival rates in DM patients for age > 50 years (p = 0.002), the presence of vascular invasion (p = 0.096), tumors ≤ 3 cm (p = 0.047), two to three tumor nodules (p = 0.007), Child-Pugh grade B (p = 0.018), and pre-LT alanine aminotransferase levels between 40 and 80 IU/L (p = 0.017) were significantly lower than in non-DM patients. Additionally, serum α-fetoprotein level > 2000 ng/ml (p = 0.052) was associated with a significant survival difference trend between DM and non-DM patients. Multivariate analysis showed that the presence of DM (p < 0.001, HR = 1.591; 95%CI: 1.239-2.041) was an independent predictor associated with poor survival after LT. CONCLUSION: HBV-related HCC patients with DM have decreased long-term overall survival and poor LT outcomes. Prevention strategies for HCC patients with DM are recommended.
KW - Diabetes mellitus
KW - Hepatitis B virus
KW - Hepatocellular carcinoma
KW - Liver transplantation
KW - Survival
UR - https://www.scopus.com/pages/publications/84995923213
U2 - 10.3748/wjg.v22.i43.9571
DO - 10.3748/wjg.v22.i43.9571
M3 - 文章
C2 - 27920478
AN - SCOPUS:84995923213
SN - 1007-9327
VL - 22
SP - 9571
EP - 9585
JO - World Journal of Gastroenterology
JF - World Journal of Gastroenterology
IS - 43
ER -
