Associations of Type 2 Diabetes with Tumor Budding and Microvascular Invasion in Resected Hepatocellular Carcinoma

Purpose

Type 2 diabetes mellitus (DM) may influence invasive tumor phenotypes in hepatocellular carcinoma (HCC). We evaluated associations of pre-existing DM with tumor budding (TB), microvascular invasion (MVI), and postoperative outcomes. Patients and methods: This single-center retrospective cohort included 924 patients with pathologically confirmed HCC who underwent curative-intent hepatectomy from 2015 to 2020. Two blinded pathologists assessed TB and MVI. Logistic regression evaluated pathological associations, and Kaplan-Meier and Cox models evaluated recurrence-free survival (RFS) and overall survival (OS). Glycemic and treatment analyses in patients with DM were exploratory and used variable-specific available cases.