Hyperglycemia-Associated Early Hepatocellular Carcinoma Recurrence After Open Radical Hepatectomy

Abstract

BackgroundWe investigated the impact of elevated glucose levels on the early recurrence of hepatocellular carcinoma (HCC)after open radical hepatectomy.MethodsThis retrospective cohort study analyzed. The clinical data of 112 patients with hepatocellular carcinoma who underwent open radical hepatectomy from January 2013 to December 2014 at the Affiliated Hospital of Qingdao University. After radical resection of the hepatocellular carcinoma, 86 patients with an average fasting blood glucose(FBG) level of 3.9–6.1 mmol/L and 26 patients with an FBG level ≥ 6.1 mmol/L were divided into the normal group and hyperglycemic group, respectively. The recurrence rate of hepatocellular carcinoma was compared between the two groups 1 and 2 years after the operation.ResultsThe postoperative 1- and 2-year recurrence rates of HCC were 19.8% (17/86) and 33.7% (29/86), respectively, in the normal group and42.3% (11/26) and 61.5% (16/26), respectively, in the hyperglycemic group; there were significant differences between the two groups (χ2 = 6.719,P = 0.01;χ2 = 6.427༌P = 0.011). The univariate analysis showed that FBG, history of alcohol drinking, extent of hepatectomy, histopathological differentiation, maximal tumor diameter, satellite lesion, and the postoperative adjuvant treatment were risk factors affecting the tumor-free survival rate after open radical resection of hepatocellular carcinoma (P < .05).The results of the multivariate analysis showed that FBG levels ≥ 6.1 mmol/L, low histopathological differentiation, and no postoperative adjuvant treatment were independent risk factors affecting tumor-free survival rate after radical resection of hepatocellular carcinoma (P < .05).ConclusionAn elevated FBG level has a stimulating effect on the early recurrence of tumor after open radical resection of hepatocellular carcinoma. Therefore, postoperative monitoring and blood glucose control may facilitate a decrease in the early recurrence rate in patients with hepatocellular carcinoma.