Diabetes mellitus and postoperative blood glucose value help predict posthepatectomy liver failure in patients with hepatocellular carcinoma

Luo, Jianchen; Xu, Liangliang; Lian, Li; Zhang, Jingfu; Zhang, Ming; Xu, Mingqing

doi:10.21037/jgo-21-491

Cited by 7 publications

(7 citation statements)

References 35 publications

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“…Although it is not the most identified patient related risk factor, the presence of diabetes has been proven to be significantly associated with a risk of PHLF. 30,31 As demonstrated in several previous studies, 6,29,32 volume does not necessarily correlate with liver function, usually underestimating it. This can be explained by several aspects.…”

Section: Discussionmentioning

confidence: 75%

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Tc‐99m mebrofenin hepatobiliary scintigraphy to assess future liver remnant function before major liver surgery

Smet,

Martin,

Uldry

et al. 2023

Journal of Surgical Oncology

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Background and ObjectivesAssessment of liver function is paramount before hepatectomy. This study aimed to assess future liver remnant function (FLR‐F) using hepatobiliary scintigraphy (HBS) and to compare it to FLR volume (FLR‐V) in the prediction of posthepatectomy liver failure (PHLF). The impact of volume and function gains were also assessed in patients undergoing portal vein embolization (PVE) or liver venous deprivation (LVD).MethodsAll consecutive patients undergoing major hepatectomy between 02/2018 and 09/2021 with preoperative HBS were included. FLR‐V was expressed as percentage of total liver volume and analyzed using preoperative computed tomography. FLR‐V and FLR‐F gains after embolization were expressed in percentage. Receiver operating characteristic analysis was performed to compare both methods in predicting PHLF.ResultsThirty‐six patients were included. PVE and LVD were performed in 4 (11%) and 28 patients (78%), respectively. Overall, PHLF occurred in eight patients (22%). FLR‐F gain after embolization showed significant ability to predict PHLF (area under the curve [AUC] = 0.789), with cut‐off value of 150% showing a sensitivity of 1.00, a specificity of 0.42, and a negative predictive value of 1.00.ConclusionPreoperative HBS shows a high sensitivity to predict PHLF when HBS is performed twice to measure the function gain after venous embolization.

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Section: Discussionmentioning

confidence: 75%

“…Concerning patient related data, both groups were equivalent except regarding diabetes. Although it is not the most identified patient related risk factor, the presence of diabetes has been proven to be significantly associated with a risk of PHLF 30,31 …”

Section: Discussionmentioning

confidence: 99%

Tc‐99m mebrofenin hepatobiliary scintigraphy to assess future liver remnant function before major liver surgery

Smet,

Martin,

Uldry

et al. 2023

Journal of Surgical Oncology

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“…Recently, LLR is gradually replacing traditional open hepatectomy, and has become the mainstream surgical method for HCC due to its advantages of minimal invasiveness ( 15 , 16 ). In several OLR study series, preoperative T2DM has been reported to be associated with an increased risk of postoperative morbidities ( 17 , 33 ) and have a direct negative impact on survival of HCC ( 34 – 36 ). While LLR is gaining a rapid popularity among liver surgeons, however, little is known regarding the downstream effect of T2DM after such an approach.…”

Section: Discussionmentioning

confidence: 99%

“…Two propensity score matching (PSM) studies showed that LLR is as safe and effective as open liver resection (OLR) for HCC patients ( 15 , 16 ). In previous OLR series, pre-existing T2DM was reported to have direct negative impact on short-term postoperative outcomes and long-term prognosis ( 17 , 18 ). Wang et al ( 19 ).…”

Section: Introductionmentioning

confidence: 99%

Impact of type 2 diabetes mellitus on the prognosis of patients with hepatocellular carcinoma after laparoscopic liver resection: A multicenter retrospective study

Yang

Yan²,

Feng³

et al. 2022

Front. Oncol.

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BackgroundThe effect of type 2 diabetes mellitus (T2DM) on survival of patients with hepatocellular carcinoma (HCC) after laparoscopic liver resection (LLR) has not been reported. This study aimed to explore the relationship between preoperative T2DM and long-term prognosis in HCC patients undergoing LLR.MethodsHCC patients receiving LLR as initial treatment at four cancer centers were retrospectively included in this study. Clinicopathological factors associated with the prognosis of HCC patients were identified using univariate and multivariate Cox regression analysis. Recurrence-free survival (RFS) and overall survival (OS) curves between different cohorts of patients were generated using the Kaplan-Meier method and compared using the log-rank test.ResultsOf 402 HCC patients included, 62 patients had T2DM and 340 patients did not have T2DM. The OS and RFS of patients with T2DM were significantly worse compared to those without T2DM (P = 0.001 and 0.032, respectively). In Cox multivariate analysis, T2DM was identified as an independent risk factors for OS (HR = 2.31, 95% CI = 1.38–3.85, P = 0.001) and RFS (HR = 1.66, 95% CI = 1.08–2.55, P = 0.020).ConclusionsFollowing laparoscopic surgical approach, HCC patients with T2DM had poorer prognoses than those without T2DM. Preoperative T2DM was an independent risk factor for HCC patients. Thus, patients with concurrent HCC and T2DM should be closely monitored after LLR.

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“…LR is a synchronized multistep process consisting of initiation (2 to 6 h), proliferation (12 to 72 h) and termination (120 to 168 h) [ 8 , 9 ]. However, the regeneration potential of liver is often impaired by pathological factors, such as liver failure and liver cirrhosis [ 10 , 11 ], thus it is worth emphasizing the necessity of finding novel channels to improve liver’s regenerative potential.…”

Section: Introductionmentioning

confidence: 99%

Overexpression of miR-125a-5p Inhibits Hepatocyte Proliferation through the STAT3 Regulation In Vivo and In Vitro

Zhao

Wang

Qin

et al. 2022

IJMS

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microRNAs (miRNAs) are critically involved in liver regeneration (LR). miR-125a-5p (miR-125a) is a tumor-suppressing miRNA, but its role in LR has not been studied. Our previous studies have proved that miR-125a was related to LR at the initiation phase, while the mechanism hepatocyte proliferation triggered by miR-125a in LR has been rarely evaluated. Herein, we mainly studied the molecular mechanism of miR-125a in triggering hepatocyte proliferation and the proliferation stage of LR. Firstly, a striking reduction of miR-125a was found at 24 h as well as 30 h following partial hepatectomy (PH) in rat liver tissue by miRNAs expression profiles as well as qRT-PCR analysis. Furthermore, in vitro, upregulation of miR-125a decreased proliferation as well as G1/S conversion, which promoted hepatocytes apoptosis. STAT3 was the target of miR-125a. In vivo, upregulation of miR-125a by tail vein injection of agomir inhibited LR index. Upregulation of miR-125a inhibited LR index and hepatocytes proliferation by STAT3/p-STAT3/JUN/BCL2 axis. In summary, these current discoveries indicated that miR-125a inhibited hepatocytes proliferation as well as LR by targeting STAT3 and via acting on the STAT3/p-STAT3/JUN/BCL2 axis.

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Diabetes mellitus and postoperative blood glucose value help predict posthepatectomy liver failure in patients with hepatocellular carcinoma

Cited by 7 publications

References 35 publications

Tc‐99m mebrofenin hepatobiliary scintigraphy to assess future liver remnant function before major liver surgery

Tc‐99m mebrofenin hepatobiliary scintigraphy to assess future liver remnant function before major liver surgery

Impact of type 2 diabetes mellitus on the prognosis of patients with hepatocellular carcinoma after laparoscopic liver resection: A multicenter retrospective study

Overexpression of miR-125a-5p Inhibits Hepatocyte Proliferation through the STAT3 Regulation In Vivo and In Vitro

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