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Original Article

Role of diabetes mellitus on the recurrence rate of
Role of diabetes mellitus on the recurrence rate of
hepatocellular carcinomas after radiofrequency ablation in
hepatocellular carcinomas after radiofrequency ablation in
chronic hepatitis C patients
chronic hepatitis C patients

Abd Allah Ahmed El-Sawy, Mohamed Abd El-Raouf Tawfik
Hepatogastroenterology and Endoscopy Unit, Internal Medicine Department, Tanta University Hospital, Tanta 31527, Egypt

ABSTRACT
Aim: The aim was to assess the impact of hyperglycemia on the recurrence of hepatocellular carcinoma (HCC) as well as
evaluate survival after curative ablation by radiofrequency. Methods: This study, which was conducted retrospectively on
107 chronic hepatitis C (CHC) patients with 159 HCCs, was presented to the Hepatology Unit of Internal Medicine Department
at Tanta University Hospitals. All lesions were curatively treated by radiofrequency ablation (RFA) and the surveillance of HCC
recurrence was evaluated radiologically every 3 months for periods between 6 and 36 months. Of 107 subjects, 70 were males
and 37 were females, with mean age 50.4 ± 9.4 years. All patients were divided according to their glycemic state into the
following three groups: Group I, which included 37 type 2 diabetic patients, with adequate maintenance of blood glucose, has
52 HCCs; Group II, which included 25 type 2 diabetic patients with inadequate maintenance of blood glucose, has 43 HCCs;
and Group III, which included 45 euglycemic non-diabetic patients, has 64 HCCs. Results: Our results showed that, there
was signifi cant increase in recurrence rate in diabetic patients with inadequate maintenance of blood glucose (Group II)
compared to those in Group I and Group III (P < 0.0001). Interestingly, there was no signifi cant difference concerning HCC
recurrence between diabetic patients with adequate maintenance of blood glucose (Group I) and non-diabetic euglycemic
patients (Group III). Our results also identifi ed that, inadequate maintenance of blood glucose in diabetic patients was also a
signifi cant predictor of poor survival. Conclusion: Inadequate maintenance of blood glucose in diabetic patients is a signifi cant
risk factor for recurrence of HCC and for poor survival after curative RFA therapy in CHC patients.

Key words: Hepatocellular carcinoma; hyperglycemia; radio frequency ablation; recurrence; survival

Address for correspondence:
Dr. Mohamed Abd El-Raouf Tawfi k, Hepatogastroenterology and Endoscopy Unit, Internal Medicine Department, Tanta University Hospital,
Tanta 31527, Egypt. E-mail: M_atawfi k@hotmail.com
Received: 30-12-2014, Accepted: 03-03-2015

INTRODUCTION cases and the third most common cause of cancer-related
deaths. [2]
Hepatocellular carcinoma (HCC) is considered as one of
the most common cancers worldwide and its incidence has There is considerable geographical variation in the incidence
been increasing in many countries. It accounts for 80% of of HCC, which is thought to be related to differences in the
[1]
primary liver cancers, complicating liver cirrhosis in most prevalence of underlying risk factors, in particular hepatitis
B virus (HBV) and hepatitis C virus (HCV) infections. [3]
Access this article online
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Website: Hepatocellular carcinoma surgical resection, liver
http://www.hrjournal.net/ transplantation, and local ablation therapy, such as radio
frequency ablation (RFA) therapy, have been considered as
[4]
efficient curative therapies for HCC. Currently, RFA has
DOI:
10.4103/2394-5079.154356 gained popularity based on the ease of use, safety, reasonable
[5]
cost and applicability to minimally invasive techniques.

24 Hepatoma Research | Volume 1 | Issue 1 | April 15, 2015