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Turkish journal of medical sciences
Oct, 2022;52 (5): 1580-1590.

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

Noor Atika Azit, Shahnorbanun Sahran, Leow Voon Meng, Manisekar K Subramaniam, Suryati Mokhtar, Azmawati Mohammed Nawi
Author Information
  1. Noor Atika Azit: 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. Shahnorbanun Sahran: Centre for Artificial Intelligence Technology (CAIT), Faculty of Information Science and Technology, National University of Malaysia, Selangor, Malaysia.
  3. Leow Voon Meng: 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. Manisekar K Subramaniam: Department of Surgery, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Kedah, Malaysia.
  5. Suryati Mokhtar: Department of Surgery, Hospital Selayang, Ministry of Health Malaysia, Selangor, Malaysia.
  6. Azmawati Mohammed Nawi: Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia.
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.

Keywords

Hepatocellular carcinoma liver neoplasm prognosis retrospective studies type 2 diabetes mellitu

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MeSH Term

Humans
Carcinoma, Hepatocellular
Liver Neoplasms
Diabetes Mellitus, Type 2
Prognosis
Non-alcoholic Fatty Liver Disease
Retrospective Studies
Alkaline Phosphatase
Metformin
Antiviral Agents

Chemicals

Alkaline Phosphatase
Metformin
Antiviral Agents
Journal Article

Word Cloud

Created with Highcharts 10.0.01=survivalAHRfactors0prognosticHCC2treatment95%CI:outcomescarcinomatypediabetesretrospectivestudy95%associatedhepatocellularT2Dpatientscohortusing2%82medicationraisedalkalinephosphatasemetforminpoorprognosishepatitisCI:liverNAFLD50familyhistorymalignanciesgoodBACKGROUND:determineMETHODS:involvingtwohepatobiliarycentresJanuary2012June302018MedicalrecordsanalysedsociodemographicclinicalcharacteristicslaboratorytestinginformationSurvivalexaminedKaplan-Meierlog-ranktestPrognosticdeterminedmultivariateCoxregressionRESULTS:total212includedmediantime22months1-3-5-yearrates6434180%respectivelyPalliativeadjustedhazardratio[AHR]confidenceinterval[CI]75-452tumoursize≥5cm0245-2traditional9427-2987425-2424403-200significantlyAntiviral5434-087nonalcoholicfattydisease30-08426-096identifiedDISCUSSION:Traditionaladvancedstageantiviralcasescomorbidamongpatients:two-centreHepatocellularneoplasmstudiesmellitu

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