Meta-analysis: The efficacy of metformin and other anti-hyperglycemic agents in prolonging the survival of hepatocellular carcinoma patients with type 2 diabetes
Meta-analysis: The efficacy of metformin and other anti-hyperglycemic agents in prolonging the survival of hepatocellular carcinoma patients with type 2 diabetes
复制标题
荟萃分析：二甲双胍和其他降糖药在延长合并2型糖尿病的肝细胞癌患者生存方面的功效。
DOI：
10.1016/j.aohep.2019.11.008
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发表时间：
2020-05-01
影响因子：
3.8
通讯作者：
Wang, Lin
中科院分区：
文献类型：
--
作者：
Zhou, Jian;Ke, Yang;Wang, Lin
前言：本研究旨在比较二甲双胍与其他抗高血糖药对肝细胞癌合并2型糖尿病(T2D)患者的疗效。材料：应用计算机检索Medline、EMBASE等电子数据库，检索包括肝细胞癌及不同抗高血糖药在内的关键词。主要结果是总存活率(OS)。结果：共纳入6篇回顾性队列研究，其中4篇为肝细胞癌根治性治疗研究，其中618例为二甲双胍治疗，532例为其他降血糖药物治疗，2篇为非治疗研究，其中92例为二甲双胍治疗，57例为其他抗高血糖药物治疗。二甲双胍治疗后OS(1年=2.62，95%CI：1.76~3.90；OR3年=3.14，95%CI：2.33~4.24；OR5年=3.31年，95%CI：2.39~4.59，P<；0.00001)和RFS(OR1年=2.52，95%CI：1.84~3.44；OR3年=2.87，95%CI：2.15~3.84；ALL P<；0.00001；与其他抗高血糖药相比，治疗后OR5年=2.26，95%CI：0.94~5.45，P=0.07)。然而，这两项研究都报道了在非根治性肝癌治疗后，二甲双胍组和非二甲双胍组之间的OS和PFS率没有显著差异(I-2和GT；50%)。结论：二甲双胍显著延长了肝癌根治性治疗后合并T2D的肝癌患者的生存时间。然而，对于患有T2D的肝细胞癌患者，二甲双胍的疗效需要在非根治性治疗后进一步确定。(C)2019年南方医学基金会，A.C.埃尔塞维尔·埃斯帕纳出版，S.L.U。这是CC By-NC-ND许可证(http://creativecommons.org/licenses/by-nc-nd/4.0/).下的一篇开放获取文章
Introduction: This study aimed to compare the therapeutic efficacy of metformin and other anti-hyperglycemic agents in hepatocellular carcinoma (HCC) patients with type 2 diabetes (T2D).Materials: A systematic electronic search on keywords including HCC and different anti-hyperglycemic agents was performed through electronic databases including Medline and EMBASE. The primary outcome was the overall survival (OS). The secondary outcomes were the recurrence-free survival (RFS) and progression-free survival (PFS).Results: Six retrospective cohort studies were included for analysis: Four studies with curative treatment for HCC (618 patients with metformin and 532 patients with other anti-hyperglycemic agents) and two studies with non-curative treatment for HCC (92 patients with metformin and 57 patients with other anti-hyperglycemic agents). Treatment with metformin was associated with significantly longer OS (OR1 yr = 2.62, 95%CI: 1.76-3.90; OR3 yr = 3.14, 95%CI: 2.33-4.24; OR5 yr = 3.31, 95%CI: 2.39-4.59, all P < 0.00001) and RFS (OR1 yr = 2.52, 95%CI: 1.84-3.44; OR3 yr = 2.87, 95%CI: 2.15-3.84; all P < 0.00001; and OR5 yr = 2.26, 95%CI: 0.94-5.45, P = 0.07) rates vs. those of other anti-hyperglycemic agents after curative therapies for HCC. However, both of the two studies reported that following non-curative HCC treatment, there were no significant differences in the OS and PFS rates between the metformin and non-metformin groups (I-2 > 50%).Conclusions: Metformin significantly prolonged the survival of HCC patients with T2D after the curative treatment of HCC. However, the efficacy of metformin needs to be further determined after non-curative therapies for HCC patients with T2D. (c) 2019 Fundacion Clinica Medica Sur, A.C. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).