The effects of metformin on the survival of colorectal cancer patients with diabetes mellitus
The effects of metformin on the survival of colorectal cancer patients with diabetes mellitus
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DOI：
10.1002/ijc.26421
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发表时间：
2012-08-01
影响因子：
6.4
通讯作者：
Kim, Won Ho
中科院分区：
文献类型：
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作者：
Lee, Jin Ha;Kim, Tae Il;Kim, Won Ho
使用二甲双胍可降低癌症风险和死亡率。然而，二甲双胍对结直肠癌（CRC）临床结果的影响尚不清楚。本研究旨在评估糖尿病患者使用二甲双胍与结直肠癌死亡率之间的关系。我们确定了 595 名被诊断为 CRC 和糖尿病的患者。对两组患者进行比较； 258 名糖尿病患者服用二甲双胍，337 名糖尿病患者未服用二甲双胍。分析了患者的人口统计学、临床特征、总体死亡率和 CRC 特异性死亡率。中位随访 41 个月后，在 258 名使用二甲双胍的患者中，共有 71 例死亡（27.5%），55 例 CRC 特异性死亡（21.3%），而在 337 名未使用二甲双胍的患者中，总共有 136 例死亡（40.4%），104 例 CRC 特异性死亡（30.9%）。通过单变量分析，二甲双胍的使用与总体死亡率（p = 0.018）和 CRC 特异性死亡率（p = 0.042）的降低相关。调整临床相关因素后，患有糖尿病的 CRC 患者使用二甲双胍显示总体死亡率（HR，0.66；95% CI 0.4760.923；p = 0.015）和 CRC 特异性死亡率（HR，0.66；95% CI 0.450.975；p = 0.037）风险较低。患有糖尿病的结直肠癌患者使用二甲双胍可以降低结直肠癌特异性死亡率和总体死亡率的风险。
Metformin use has been associated with decreased cancer risk and mortality. However, the effects of metformin on clinical outcomes of colorectal cancer (CRC) are not defined. This study aimed to evaluate the association between metformin use and mortality of CRC in diabetic patients. We identified 595 patients who were diagnosed both CRC and diabetes mellitus. Patients were compared by two groups; 258 diabetic patients taking metformin and 337 diabetic patients not taking metformin. Patient's demographics, clinical characteristics, overall mortality and CRC-specific mortality were analyzed. After a median follow-up of 41 months, there were 71 total deaths (27.5%) and 55 CRC-specific deaths (21.3%) among 258 patients who used metformin, compared with 136 total deaths (40.4%) and 104 CRC-specific deaths (30.9%) among 337 patients who did not use metformin. Metformin use was associated with decreased overall mortality (p = 0.018) and CRC-specific mortality (p = 0.042) by univariate analysis. After adjustment for clinically relevant factors, metformin use showed lower risk of overall mortality (HR, 0.66; 95% CI 0.4760.923; p = 0.015) and CRC-specific mortality (HR, 0.66; 95% CI 0.450.975; p = 0.037) in CRC patients with diabetes. Metformin use in CRC patients with diabetes is associated with lower risk of CRC-specific and overall mortality.