Hyperglycemia is a significant prognostic factor of hepatocellular carcinoma after curative therapy

Figure 1 Kaplan-Meier curves showing a higher rate of hepatocellular carcinoma recurrence in diabetic patients with hyperglycemia. A: The cumulative incidence of the recurrence of hepatocellular carcinoma (HCC) was significantly higher in diabetic patients with inadequate maintenance of blood glucose (blood glucose ≥ 200 mg/dL solid line) than in the others (dotted line) (P = 0.0001); B: The HCC recurrence rate was significantly higher in diabetic patients with inadequate maintenance of blood glucose (solid line) than in diabetic patients with adequate maintenance of blood glucose (blood glucose < 200 mg/dL, broken line) or non-diabetic patients (dotted line) (P = 0.0001). There was no significant difference in HCC recurrence rate between diabetic patients with adequate maintenance of blood glucose and non-diabetic patients.

Figure 2 Diabetic patients with inadequate maintenance of blood glucose have higher rate of hepatocellular carcinoma recurrence after stratification by other risk factors. A: P = 0.006 for single hepatocellular carcinoma (HCC) nodule; B: P = 0.025 for multiple HCC nodules; C: P = 0.005 for AFP ≥ 100 ng/mL; D: P = 0.017 for α-fetoprotein (AFP) < 100 ng/mL. The cumulative incidence of the recurrence of HCC was significantly higher in diabetic patients with inadequate maintenance of blood glucose (solid line) than in the others (dotted line). after stratification by number of HCC nodules and by initial level of AFP.

Figure 3 Kaplan-Meier curves showing a higher rate of second recurrence of hepatocellular carcinoma in diabetic patients with inadequate maintenance of blood glucose. A: The cumulative incidence of the second recurrence of hepatocellular carcinoma (HCC) was significantly higher in diabetic patients with inadequate maintenance of blood glucose (blood glucose ≥ 200 mg/dL solid line) than in the others (dotted line) (P = 0.002); B: The rate of second recurrence of HCC was significantly higher in diabetic patients with inadequate maintenance of blood glucose (solid line) than in diabetic patients with adequate maintenance of blood glucose (blood glucose < 200 mg/dL, broken line) or non-diabetic patients (dotted line) (P = 0.004). There was no significant difference in the rate of second recurrence of HCC between diabetic patients with adequate maintenance of blood glucose and non-diabetic patients.

Figure 4 Patients with inadequate maintenance of blood glucose have a lower survival rate. A: The survival rate after curative local ablation therapy for hepatocellular carcinoma (HCC) was significantly lower in diabetic patients with inadequate maintenance of blood glucose (blood glucose ≥ 200 mg/dL solid line) than in the others (dotted line) (P = 0.0003); B: The survival rate was significantly lower in diabetic patients with inadequate maintenance of blood glucose (solid line) than in diabetic patients with adequate maintenance of blood glucose (blood glucose < 200 mg/dL, broken line) or non-diabetic patients (dotted line) (P = 0.0003). There was no significant difference in survival rate between diabetic patients with adequate maintenance of blood glucose and non-diabetic patients.