Diabetes is a known risk factor for developing hepatocellular carcinoma (HCC). Reported rates of diabetes are higher in chronic hepatitis, cirrhosis and HCC patients. However, its effects on postoperative recurrence and survival with HCC are controversial. This study offers a retrospective analysis of the impacts of diabetes on postoperative recurrence and survival in patients with cirrhosis and HCC. A total of 389 cirrhotic patients who underwent curative resection for primary HCC at our institution between January 2000 and December 2008 were enrolled. Of them, 272 (70%) patients were classified into a non-diabetes group and 117 (30%) patients into the diabetes group. The diabetes group was divided into an oral hypoglycemic agent (OHA) control group (n = 100) and an insulin control group (n = 17). The result indicates that the diabetes group had a higher postoperative recurrence rate and poorer long-term survival rate (p = 0.001 vs. 0.01). There was no significant difference in recurrence-free survival rate between the OHA control group and the insulin control group (p = 0.17). The insulin control group had a poorer long-term surgical outcome than the OHA control group (p = 0.035). In conclusion, our results suggest that diabetes is an independent risk factor for postoperative recurrence and surgical survival of cirrhotic HCC patients. Cirrhotic HCC patients with diabetes who received hepatic resection should be closely followed-up for postoperative recurrence and long-term outcome. Moreover, an effective peri-operative sugar control planning in HCC patients with diabetes should be established.
This study aimed to determine the effectiveness of using noninvasive arterial pulse-wave and laser-Doppler flowmetry (LDF) measurements to discriminate between colorectal-cancer (CC) patients and healthy control subjects. Radial-artery blood pressure waveform (BPW), finger photoplethysmography (PPG), and skin-surface LDF signals were measured noninvasively in 12 CC patients and 25 control subjects. Beat-to-beat, spectral, and variability analyses were applied to 20-minute-long recorded signals. Significant intergroup differences were found. In BPW, [Formula: see text]–[Formula: see text] amplitude indices were significantly larger while [Formula: see text]–[Formula: see text] phase-angle indices were significantly smaller in the CC patients than in the controls. The PPG and LDF variability indices were significantly larger and smaller, respectively, in CC patients. The relative energy contributions of the endothelial-, neural-, and myogenic-related frequency bands in LDF were significantly smaller in CC patients. The present findings indicate that pulse and LDF waveform analysis can be used to evaluate the arterial pulse-wave transmission condition, the responses of the blood-flow perfusion, and its regulatory activities in CC patients. There could be some similarities and differences in the present indices for different types of cancer. These findings could be utilized in the development of a rapid, noninvasive, and objective technique for evaluating the CC-induced blood-flow responses.
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