Diabetes mellitus and poorer prognosis in hepatocellular carcinoma: a systematic review and meta-analysis.
BACKGROUND: Previous studies suggested that diabetes mellitus was associated with cancer risk and prognosis, but studies investigating the relationship between diabetes mellitus and survival in patients with hepatocellular carcinoma (HCC) reported inconsistent findings. To derive a more precise esti...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2014-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4022589?pdf=render |
| _version_ | 1811282218249617408 |
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| author | Yan-Gang Wang Peng Wang Bin Wang Zheng-Ju Fu Wen-Juan Zhao Sheng-Li Yan |
| author_facet | Yan-Gang Wang Peng Wang Bin Wang Zheng-Ju Fu Wen-Juan Zhao Sheng-Li Yan |
| author_sort | Yan-Gang Wang |
| collection | DOAJ |
| description | BACKGROUND: Previous studies suggested that diabetes mellitus was associated with cancer risk and prognosis, but studies investigating the relationship between diabetes mellitus and survival in patients with hepatocellular carcinoma (HCC) reported inconsistent findings. To derive a more precise estimate of the prognostic role of diabetes mellitus in HCC, we systematically reviewed published studies and carried out a meta-analysis. METHODS: Eligible articles were identified in electronic databases from their inception through September 16, 2013. To evaluate the correlation between diabetes mellitus and prognosis in HCC, the pooled hazard ratios (HR) and their 95% confidence intervals (95% CI) for poorer overall and disease-free survivals were calculated by standard meta-analysis techniques with fixed-effects or random-effects models. RESULTS: 21 studies with a total of 9,767 HCC patients stratifying overall survival and/or disease-free survival in HCC patients by diabetes mellitus status were eligible for meta-analysis. 20 studies with a total of 9,727 HCC cases investigated the overall survival, and 10 studies with a total of 2,412 HCC patients investigated the disease-free survival. The pooled HRs for overall survival and disease-free survival were 1.46 (95% CI, 1.29 to 1.66; P<0.001) and 1.57 (95% CI, 1.21 to 2.05; P = 0.001), respectively. The adjusted HRs for overall survival and disease-free survival were 1.55 (95% CI, 1.27 to 1.91; P<0.001) and 2.15 (95% CI, 1.75 to 2.63; P<0.001), respectively. In addition, for patients receiving hepatic resection, diabetes mellitus was associated with both poorer overall survival and poorer disease-free survival, and for patients receiving non-surgical treatment or patients receiving radiofrequency ablation, diabetes mellitus was associated with poorer overall survival. There was no evidence for publication bias. CONCLUSION: Diabetes mellitus is independently associated with both poorer overall survival and poorer disease-free survival in HCC patients. |
| first_indexed | 2024-04-13T01:48:48Z |
| format | Article |
| id | doaj.art-bb95c35e51fc4bf4824b8915a4626514 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-13T01:48:48Z |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-bb95c35e51fc4bf4824b8915a46265142022-12-22T03:07:57ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0195e9548510.1371/journal.pone.0095485Diabetes mellitus and poorer prognosis in hepatocellular carcinoma: a systematic review and meta-analysis.Yan-Gang WangPeng WangBin WangZheng-Ju FuWen-Juan ZhaoSheng-Li YanBACKGROUND: Previous studies suggested that diabetes mellitus was associated with cancer risk and prognosis, but studies investigating the relationship between diabetes mellitus and survival in patients with hepatocellular carcinoma (HCC) reported inconsistent findings. To derive a more precise estimate of the prognostic role of diabetes mellitus in HCC, we systematically reviewed published studies and carried out a meta-analysis. METHODS: Eligible articles were identified in electronic databases from their inception through September 16, 2013. To evaluate the correlation between diabetes mellitus and prognosis in HCC, the pooled hazard ratios (HR) and their 95% confidence intervals (95% CI) for poorer overall and disease-free survivals were calculated by standard meta-analysis techniques with fixed-effects or random-effects models. RESULTS: 21 studies with a total of 9,767 HCC patients stratifying overall survival and/or disease-free survival in HCC patients by diabetes mellitus status were eligible for meta-analysis. 20 studies with a total of 9,727 HCC cases investigated the overall survival, and 10 studies with a total of 2,412 HCC patients investigated the disease-free survival. The pooled HRs for overall survival and disease-free survival were 1.46 (95% CI, 1.29 to 1.66; P<0.001) and 1.57 (95% CI, 1.21 to 2.05; P = 0.001), respectively. The adjusted HRs for overall survival and disease-free survival were 1.55 (95% CI, 1.27 to 1.91; P<0.001) and 2.15 (95% CI, 1.75 to 2.63; P<0.001), respectively. In addition, for patients receiving hepatic resection, diabetes mellitus was associated with both poorer overall survival and poorer disease-free survival, and for patients receiving non-surgical treatment or patients receiving radiofrequency ablation, diabetes mellitus was associated with poorer overall survival. There was no evidence for publication bias. CONCLUSION: Diabetes mellitus is independently associated with both poorer overall survival and poorer disease-free survival in HCC patients.http://europepmc.org/articles/PMC4022589?pdf=render |
| spellingShingle | Yan-Gang Wang Peng Wang Bin Wang Zheng-Ju Fu Wen-Juan Zhao Sheng-Li Yan Diabetes mellitus and poorer prognosis in hepatocellular carcinoma: a systematic review and meta-analysis. PLoS ONE |
| title | Diabetes mellitus and poorer prognosis in hepatocellular carcinoma: a systematic review and meta-analysis. |
| title_full | Diabetes mellitus and poorer prognosis in hepatocellular carcinoma: a systematic review and meta-analysis. |
| title_fullStr | Diabetes mellitus and poorer prognosis in hepatocellular carcinoma: a systematic review and meta-analysis. |
| title_full_unstemmed | Diabetes mellitus and poorer prognosis in hepatocellular carcinoma: a systematic review and meta-analysis. |
| title_short | Diabetes mellitus and poorer prognosis in hepatocellular carcinoma: a systematic review and meta-analysis. |
| title_sort | diabetes mellitus and poorer prognosis in hepatocellular carcinoma a systematic review and meta analysis |
| url | http://europepmc.org/articles/PMC4022589?pdf=render |
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