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

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