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J BUON. 2018 Jul-Aug;23(4):958-964.

Diabetes mellitus may worsen the prognosis in hepatocellular carcinoma patients undergoing curative microwave ablation.

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Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.



This study aimed to investigate the outcomes of hepatocellular carcinoma (HCC) patients after curative microwave ablation (MWA) with and without diabetes mellitus (DM).


A total of 308 patients with HCC were retrospectively studied from 2005 to 2012 over an 8-year period. They were all successfully treated by MWA. Progression-free survival (PFS) and overall survival (OS) were analyzed according to the status of DM. The presence of other comorbidities and tumor status were studied using multivariate analysis.


Significant differences were observed both for 1-, 3-, 5- year's PFS rates (DM: 63.8, 23.0 and 15.8 vs non-DM: 72.7, 43.6 and 30.8%; p=0.013) and OS rates (DM: 87.3, 75.1 and 49.5% vs non-DM: 97.9, 82.9 and 70.5%; p=0.045) between patients with and without DM. Cox multivariate analysis identified the following factors significantly associated with PFS: (hazard ration (HR): 1.191, 95% CI: 1.051-1,349, p=0.006), AFP (HR:1.000, 95% CI: 1.000-1.000, p=0.022), alcohol abuse (>100g/d vs ≤100g/d, HR:1.579, 95% CI:1.128- 2.212, p=0.008), mean fasting plasma glucose level after initial therapy for HCC(>7.0 / ≤7.0, HR:2.728, 95%CI:1.414- 5.265, p=0.003); and the followings associated with OS:Child-Pugh classification A against B, C (risk 1.692, 95%CI 1.065-2.689, P=0.026), tumor diameter (risk 1.251. 95% CI 1.021-1.534, P=0.031), and AFP (risk 1.000. 95% CI 1.000- 1.000, P=0.000).


DM may affect the HCC progression and overall survival in patients undergoing curative MWA. A good control of the glucose levels after ablation may be important for improving the prognosis of HCC.


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