Hepatobiliary Surg Nutr: High HbA1c is a risk factor for complications after hepatectomy and has an impact on hepatocellular carcinoma without hepatitis infection

Background: Type 2 diabetes (DM) is caused by impaired insulin secretion and/or resistance, leading to the occurrence of hyperglycemia
.

Patients with liver disease usually have insulin resistance at the same time

Patients with liver disease usually have insulin resistance at the same time

We compared the prognosis of survival, recurrence, clinicopathological characteristics, surgical outcome and morbidity of H-A1c group and L-A1c group
.

In addition, we evaluated the effect of diabetes treatment on the prognosis of HCC patients (NBNC patients) without HBV and HCV

The indications and surgical methods of hepatectomy are usually determined according to the patient's liver function reserve, that is, the results of the 15-min indocyanine green retention test (ICGR15)
.

Anatomical resection refers to the complete anatomical resection of the lesion according to Couinaud's classification (segmentectomy, biopsy, hemihepatectomy or above) for patients whose ICGR15 is less than 25%

The postoperative morbidity was assessed using the effective classification system of Clavien-Dindo
.

Severe complications are classified into grades III-V and are defined as the morbidity that requires surgery or radiation therapy

Results: Among all patients and those infected with hepatitis B virus (HBV) and hepatitis C virus (HCV), the overall survival (OS) and recurrence-free survival (RFS) of the H-A1c group and the L-A1c group were not Significant difference
.

In contrast, among patients without HBV and HCV infection (NBNC patients), the 5-year OS rates in the H-A1c group and L-A1c group were 55% and 71%, respectively (P=0.

Figure 1 Overall survival curve: (A) all HCC patients; (B) HCC patients based on NBNC
.

Liver cancer, hepatocellular carcinoma; NBNC NonBNonC

Figure 1 Overall survival curve: (A) all HCC patients; (B) HCC patients based on NBNC

Figure 2 Recurrence-free survival curve: (A) all HCC patients; (B) NBNC-based HCC patients
.

Liver cancer, hepatocellular carcinoma; NBNC NonBNonC

Figure 2 Recurrence-free survival curve: (A) all HCC patients; (B) NBNC-based HCC patients
.
Liver cancer, hepatocellular carcinoma; NBNC NonBNonC
.

Table 1 Clinicopathological characteristics of NBNC-HCC

Table 1 Clinicopathological characteristics of NBNC-HCC

Table 2 Prognostic factors for survival and recurrence of NBNC-HCC

Table 2 Prognostic factors for survival and recurrence of NBNC-HCC

Figure 3 (A) Diabetic patients' overall survival curve and (B) Diabetic patients' recurrence-free survival curve
.

Figure 3 (A) Diabetic patients' overall survival curve and (B) Diabetic patients' recurrence-free survival curve
.

Table 3 Results of the operation

Table 3 Results of the operation

Conclusion: The prognosis of liver cancer patients with elevated HbA1c may be poor in survival and recurrence in NBNC-HCC
.
High HbA1c may also be a risk factor for morbidity after hepatectomy
.
The use of metformin may be a good choice for NBNC liver cancer patients
.

Liver cancer patients with elevated HbA1c may have a poor prognosis for survival and recurrence in NBNC-HCC
.
High HbA1c may also be a risk factor for morbidity after hepatectomy
.
The use of metformin may be a good choice for NBNC liver cancer patients
.

Original source:

Shimada S, Kamiyama T, Orimo T,et al.
High HbA1c is a risk factor for complications after hepatectomy and influences for hepatocellular carcinoma without HBV and HCV infection.
Hepatobiliary Surg Nutr 2021 Aug;10(4)

High HbA1c is a risk factor for complications after hepatectomy and influences for hepatocellular carcinoma without HBV and HCV infection.
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