Abstract
BACKGROUND AND AIM: Liver cancer is a prevalent and life-threatening condition, particularly among elderly individuals. The association between diabetes, a chronic metabolic disorder, and the onset and advancement of liver cancer has been widely acknowledged. However, the effect of diabetes on the survival of older patients with liver cancer has been a topic of debate. In light of this, we undertook a retrospective study to assess the impact of diabetes on the overall survival (OS) of elderly individuals diagnosed with liver cancer. METHODS: In this retrospective analysis, we examined clinical data from liver cancer patients aged 80 years or older who underwent diagnosis and treatment at a solitary medical center from January 2010 to December 2019. Comprehensive records encompassing baseline information, treatment protocols, diabetes history, and mortality during follow-up were meticulously documented. Employing the Kaplan-Meier method and the Cox proportional hazards model, we sought to assess the influence of diabetes on both the OS and recurrence-free survival (RFS) in elderly individuals diagnosed with liver cancer. RESULTS: This study comprised 244 elderly liver cancer patients, with 68 individuals reporting a history of diabetes. In the unadjusted Kaplan-Meier survival analysis, the diabetes group exhibited a lower OS compared to the non-diabetes group. Utilizing a multivariate Cox proportional hazards model, diabetes emerged as a prognostic factor influencing OS (hazard ratio, HR = 1.782 [1.163-2.743], P = 0.043). Regarding RFS, unadjusted Kaplan-Meier analysis revealed a diminished RFS in the diabetes group compared to the non-diabetes group. In the multivariate Cox proportional hazards model, diabetes remained a significant prognostic factor impacting RFS (HR = 1.742 [1.083-1.546], P = 0.041). CONCLUSION: Our study indicates a significant impact of diabetes on both OS and RFS among elderly liver cancer patients. These insights may contribute to more precise guidance and recommendations for the treatment of this specific demographic, offering valuable information for healthcare practitioners working with elderly individuals diagnosed with liver cancer.