The role of pre-existing diabetes mellitus on hepatocellular carcinoma occurrence and prognosis: a meta-analysis of prospective cohort studies.
The impact of pre-existing diabetes mellitus (DM) on hepatocellular carcinoma (HCC) occurrence and prognosis is complex and unclear. The aim of this meta-analysis is to evaluate the association between pre-existing diabetes mellitus and hepatocellular carcinoma occurrence and prognosis.We searched P...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2011-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3244388?pdf=render |
| _version_ | 1819070361040322560 |
|---|---|
| author | Wan-Shui Yang Puthiery Va Freddie Bray Shan Gao Jing Gao Hong-Lan Li Yong-Bing Xiang |
| author_facet | Wan-Shui Yang Puthiery Va Freddie Bray Shan Gao Jing Gao Hong-Lan Li Yong-Bing Xiang |
| author_sort | Wan-Shui Yang |
| collection | DOAJ |
| description | The impact of pre-existing diabetes mellitus (DM) on hepatocellular carcinoma (HCC) occurrence and prognosis is complex and unclear. The aim of this meta-analysis is to evaluate the association between pre-existing diabetes mellitus and hepatocellular carcinoma occurrence and prognosis.We searched PubMed, Embase and the Cochrane Library from their inception to January, 2011 for prospective epidemiological studies assessing the effect of pre-existing diabetes mellitus on hepatocellular carcinoma occurrence, mortality outcomes, cancer recurrence, and treatment-related complications. Study-specific risk estimates were combined by using fixed effect or random effect models.The database search generated a total of 28 prospective studies that met the inclusion criteria. Among these studies, 14 reported the risk of HCC incidence and 6 studies reported risk of HCC specific mortality. Six studies provided a total of 8 results for all-cause mortality in HCC patients. Four studies documented HCC recurrence risks and 2 studies reported risks for hepatic decomposition occurrence in HCC patients. Meta-analysis indicated that pre-existing diabetes mellitus (DM) was significantly associated with increased risk of HCC incidence [meta-relative risk (RR) = 1.87, 95% confidence interval (CI): 1.15-2.27] and HCC-specific mortality (meta-RR = 1.88, 95%CI: 1.39-2.55) compared with their non-DM counterparts. HCC patients with pre-existing DM had a 38% increased (95% CI: 1.13-1.48) risk of death from all-causes and 91% increased (95%CI: 1.41-2.57) risk of hepatic decomposition occurrence compared to those without DM. In DM patients, the meta-RR for HCC recurrence-free survival was 1.93(95%CI: 1.12-3.33) compared with non-diabetic patients.The findings from the current meta-analysis suggest that DM may be both associated with elevated risks of both HCC incidence and mortality. Furthermore, HCC patients with pre-existing diabetes have a poorer prognosis relative to their non-diabetic counterparts. |
| first_indexed | 2024-12-21T17:04:43Z |
| format | Article |
| id | doaj.art-023b95f88aa74a608ceea56fc0fc551c |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-21T17:04:43Z |
| publishDate | 2011-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-023b95f88aa74a608ceea56fc0fc551c2022-12-21T18:56:33ZengPublic Library of Science (PLoS)PLoS ONE1932-62032011-01-01612e2732610.1371/journal.pone.0027326The role of pre-existing diabetes mellitus on hepatocellular carcinoma occurrence and prognosis: a meta-analysis of prospective cohort studies.Wan-Shui YangPuthiery VaFreddie BrayShan GaoJing GaoHong-Lan LiYong-Bing XiangThe impact of pre-existing diabetes mellitus (DM) on hepatocellular carcinoma (HCC) occurrence and prognosis is complex and unclear. The aim of this meta-analysis is to evaluate the association between pre-existing diabetes mellitus and hepatocellular carcinoma occurrence and prognosis.We searched PubMed, Embase and the Cochrane Library from their inception to January, 2011 for prospective epidemiological studies assessing the effect of pre-existing diabetes mellitus on hepatocellular carcinoma occurrence, mortality outcomes, cancer recurrence, and treatment-related complications. Study-specific risk estimates were combined by using fixed effect or random effect models.The database search generated a total of 28 prospective studies that met the inclusion criteria. Among these studies, 14 reported the risk of HCC incidence and 6 studies reported risk of HCC specific mortality. Six studies provided a total of 8 results for all-cause mortality in HCC patients. Four studies documented HCC recurrence risks and 2 studies reported risks for hepatic decomposition occurrence in HCC patients. Meta-analysis indicated that pre-existing diabetes mellitus (DM) was significantly associated with increased risk of HCC incidence [meta-relative risk (RR) = 1.87, 95% confidence interval (CI): 1.15-2.27] and HCC-specific mortality (meta-RR = 1.88, 95%CI: 1.39-2.55) compared with their non-DM counterparts. HCC patients with pre-existing DM had a 38% increased (95% CI: 1.13-1.48) risk of death from all-causes and 91% increased (95%CI: 1.41-2.57) risk of hepatic decomposition occurrence compared to those without DM. In DM patients, the meta-RR for HCC recurrence-free survival was 1.93(95%CI: 1.12-3.33) compared with non-diabetic patients.The findings from the current meta-analysis suggest that DM may be both associated with elevated risks of both HCC incidence and mortality. Furthermore, HCC patients with pre-existing diabetes have a poorer prognosis relative to their non-diabetic counterparts.http://europepmc.org/articles/PMC3244388?pdf=render |
| spellingShingle | Wan-Shui Yang Puthiery Va Freddie Bray Shan Gao Jing Gao Hong-Lan Li Yong-Bing Xiang The role of pre-existing diabetes mellitus on hepatocellular carcinoma occurrence and prognosis: a meta-analysis of prospective cohort studies. PLoS ONE |
| title | The role of pre-existing diabetes mellitus on hepatocellular carcinoma occurrence and prognosis: a meta-analysis of prospective cohort studies. |
| title_full | The role of pre-existing diabetes mellitus on hepatocellular carcinoma occurrence and prognosis: a meta-analysis of prospective cohort studies. |
| title_fullStr | The role of pre-existing diabetes mellitus on hepatocellular carcinoma occurrence and prognosis: a meta-analysis of prospective cohort studies. |
| title_full_unstemmed | The role of pre-existing diabetes mellitus on hepatocellular carcinoma occurrence and prognosis: a meta-analysis of prospective cohort studies. |
| title_short | The role of pre-existing diabetes mellitus on hepatocellular carcinoma occurrence and prognosis: a meta-analysis of prospective cohort studies. |
| title_sort | role of pre existing diabetes mellitus on hepatocellular carcinoma occurrence and prognosis a meta analysis of prospective cohort studies |
| url | http://europepmc.org/articles/PMC3244388?pdf=render |
| work_keys_str_mv | AT wanshuiyang theroleofpreexistingdiabetesmellitusonhepatocellularcarcinomaoccurrenceandprognosisametaanalysisofprospectivecohortstudies AT puthieryva theroleofpreexistingdiabetesmellitusonhepatocellularcarcinomaoccurrenceandprognosisametaanalysisofprospectivecohortstudies AT freddiebray theroleofpreexistingdiabetesmellitusonhepatocellularcarcinomaoccurrenceandprognosisametaanalysisofprospectivecohortstudies AT shangao theroleofpreexistingdiabetesmellitusonhepatocellularcarcinomaoccurrenceandprognosisametaanalysisofprospectivecohortstudies AT jinggao theroleofpreexistingdiabetesmellitusonhepatocellularcarcinomaoccurrenceandprognosisametaanalysisofprospectivecohortstudies AT honglanli theroleofpreexistingdiabetesmellitusonhepatocellularcarcinomaoccurrenceandprognosisametaanalysisofprospectivecohortstudies AT yongbingxiang theroleofpreexistingdiabetesmellitusonhepatocellularcarcinomaoccurrenceandprognosisametaanalysisofprospectivecohortstudies AT wanshuiyang roleofpreexistingdiabetesmellitusonhepatocellularcarcinomaoccurrenceandprognosisametaanalysisofprospectivecohortstudies AT puthieryva roleofpreexistingdiabetesmellitusonhepatocellularcarcinomaoccurrenceandprognosisametaanalysisofprospectivecohortstudies AT freddiebray roleofpreexistingdiabetesmellitusonhepatocellularcarcinomaoccurrenceandprognosisametaanalysisofprospectivecohortstudies AT shangao roleofpreexistingdiabetesmellitusonhepatocellularcarcinomaoccurrenceandprognosisametaanalysisofprospectivecohortstudies AT jinggao roleofpreexistingdiabetesmellitusonhepatocellularcarcinomaoccurrenceandprognosisametaanalysisofprospectivecohortstudies AT honglanli roleofpreexistingdiabetesmellitusonhepatocellularcarcinomaoccurrenceandprognosisametaanalysisofprospectivecohortstudies AT yongbingxiang roleofpreexistingdiabetesmellitusonhepatocellularcarcinomaoccurrenceandprognosisametaanalysisofprospectivecohortstudies |