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Diabetes, Obesity Could Raise Long-Term HCC Recurrence Risk

Patients with both obesity and diabetes saw a 2.53-fold increase in hepatocellular carcinoma recurrence beyond five years post-surgery, highlighting the critical impact of these comorbidities on long-term outcomes.

Conexiant

Patients with both obesity and diabetes mellitus undergoing hepatic resection for hepatocellular carcinoma face an increased risk of recurrence beyond five years post-surgery, according to a recent study.

The multicenter retrospective study evaluated the impact of comorbid obesity (OB) and diabetes mellitus (DM) on survival outcomes in patients undergoing hepatic resection for hepatocellular carcinoma (HCC). Researchers analyzed data from 1,644 patients without vascular invasion, categorizing them into four groups based on OB and DM status: no OB or DM (OB(−)DM(−)) with 860 patients, OB without DM (OB(+)DM(−)) with 276 patients, DM without OB (OB(−)DM(+)) with 315 patients, and both (OB(+)DM(+)) with 202 patients.

Researchers found that the coexistence of OB and DM was associated with an increased risk of late recurrence and decreased overall survival (OS). Adjusted hazard ratios (HRs) for reduced recurrence-free survival indicated a higher risk for patients in the OB(+)DM(+) group compared to those in the OB(−)DM(−) group with an HR of 1.24 (95% confidence interval [CI]: 1.01–1.54; p = 0.045). Additionally, patients with both conditions exhibited a 2.53-fold increase in the risk of recurrence beyond five years postoperatively (p = 0.046).

The adjusted HRs for reduced OS revealed that the OB(+)DM(−) group had an HR of 0.93 (95% CI: 0.73–1.19; p = 0.57). For the OB(−)DM(+) group, the HR was 0.97 (95% CI; 0.78–1.21; p = 0.76. In comparison to the OB(−)DM(−) group, the OB(+)DM(+) group showed an HR of 1.38 (95% CI: 1.07–1.77; p = 0.013).

The cumulative recurrence rates over a two-year period for the early phase were as follows: the OB(−)DM(−) group had a recurrence rate of 39%, the OB(+)DM(−) group had a rate of 35%, the OB(−)DM(+) group also had a rate of 35%, and the OB(+)DM(+) group recorded a recurrence rate of 41%.

The risk of late recurrence beyond five years was elevated in the following groups: the OB(+)DM(−) group exhibited an HR of 3.83 (p < 0.001), the OB(−)DM(+) group had an HR of 1.95 (p = 0.037), and the OB(+)DM(+) group demonstrated an HR of 2.53 (p = 0.046).

The five-year OS rates for the different groups were as follows: 71% for the OB(−)DM(−) group, 74% for the OB(+)DM(−) group, and 68% for both the OB(−)DM(+) and OB(+)DM(+) groups.

No significant differences in early recurrence rates were observed among the groups, indicating that the risks associated with obesity and diabetes mellitus may primarily affect late recurrence rather than early postoperative outcomes. These findings, published in Liver Cancer, suggested that the presence of these comorbidities may affect postoperative surveillance and treatment strategies for patients with HCC.

Full disclosures can be found in the published study.