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The survival outcomes and prognostic factors of hepatocellular carcinoma among type 2 diabetes patients: a two-centre retrospective cohort study

Azit NA 1 , Sahran S 2 , Meng LV 3 , Subramaniam MK 4 , Mokhtar S 5 , Nawi AM 6

Affiliations 

  • 1 Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia, Kuala Muda District Health Office, Ministry of Health Malaysia, Kedah, Malaysia
  • 2 Centre for Artificial Intelligence Technology (CAIT), Faculty of Information Science and Technology, National University of Malaysia, Selangor, Malaysia
  • 3 Department of Clinical Medicine, Advanced Medical and Dental Institute (AMDI), University of Science, Malaysia, Penang, Malaysia, Department of Surgery, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Kedah, Malaysia
  • 4 Department of Surgery, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Kedah, Malaysia
  • 5 Department of Surgery, Hospital Selayang, Ministry of Health Malaysia, Selangor, Malaysia
  • 6 Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
Turk J Med Sci, 2022 Oct;52(5):1580-1590.
PMID: 36422484 DOI: 10.55730/1300-0144.5498

Abstract

BACKGROUND: To determine the survival outcomes and prognostic factors associated with hepatocellular carcinoma (HCC) survival in type 2 diabetes (T2D) patients.

METHODS: This was a retrospective cohort study involving two hepatobiliary centres from January 1, 2012, to June 30, 2018. Medical records were analysed for sociodemographic, clinical characteristics, laboratory testing, and HCC treatment information. Survival outcomes were examined using the Kaplan-Meier and log-rank test. Prognostic factors were determined using multivariate Cox regression.

RESULTS: A total of 212 patients were included in the study. The median survival time was 22 months. The 1-, 3-, and 5-year survival rates were 64.2%, 34.2%, and 18.0%, respectively. Palliative treatment (adjusted hazard ratio [AHR] = 2.82, 95% confidence interval [CI] 1.75-4.52), tumour size ≥ 5 cm (AHR = 2.02, 95%CI: 1.45-2.82), traditional medication (AHR = 1.94, 95%CI: 1.27-2.98), raised alkaline phosphatase (AHR = 1.74, 95%CI: 1.25-2.42), and metformin (AHR = 1.44, 95%CI: 1.03-2.00) were significantly associated with poor prognosis for HCC survival. Antiviral hepatitis treatment (AHR = 0.54, 95% CI: 0.34-0.87), nonalcoholic fatty liver disease (NAFLD) (AHR = 0.50, 95% CI: 0.30-0.84), and family history of malignancies (AHR = 0.50, 95%CI: 0.26-0.96) were identified as good prognostic factors for HCC survival.

DISCUSSION: Traditional medication, metformin treatment, advanced stage and raised alkaline phosphatase were the poor prognostic factors, while antiviral hepatitis treatment, NAFLD, and family history of malignancies were the good prognostic factors for our HCC cases comorbid with T2D.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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