Blood sugar level affects the recurrence of hepatocellular carcinoma after laparoscopic surgery: a retrospective study
Yu, W.; Wang, Y.; Liao, G.
Journal of BUON Official Journal of the Balkan Union of Oncology 23(3): 622-628
2018
ISSN/ISBN: 1107-0625 PMID: 30003728 Document Number: 696628
To investigate the effect of blood sugar level on the recurrence of hepatocellular carcinoma (HCC) after laparoscopic surgery. The data of 177 patients with primary HCC who underwent laparoscopic radical liver resection were retrospectively analyzed. Patients were divided into the hyperglycemia group (n=56) and the control group (n=121) according to whether postoperative fasting blood sugar (FBS) was ≥6.1 mmol/L. Postoperative hospitalization and blood glucose level during follow-up were observed and recurrence and relative risk factors of HCC of patients from the two groups were analyzed. The recurrence rate of HCC after one and two years were compared between the two groups, and the influencing factors of recurrence after laparoscopic surgery were analyzed by single-factor analysis. The recurrence rate one year after surgery in patients with hyperglycemia and the control group were 30.4 and 16.5% respectively, and the recurrence rate two years after surgery were 64.3 and 37.2%, respectively. The recurrence rate one and two years after surgery in HCC patients from the hyperglycemia group were significantly higher than those of the control group (p<0.05). Multivariate analysis showed that FBS, Child-Pugh grade B, low differentiated carcinoma and high postoperative AFP were risk factors for recurrence of HCC after laparoscopic surgery, which affected significantly the disease-free survival (DFS) of postoperative HCC (p<0.05). The recurrence rate of patients with elevated FBS after laparoscopic surgery of HCC was high during the 2 postoperative years, and FBS was high, while the Child- Pugh grade B, low grade of tumor differentiation, and postoperative AFP were risk factors affecting the recurrence rate. Monitoring high-risk patients should be strengthened to reduce the recurrence rate.