Metformin associated with lower mortality in diabetic patients with early stage hepatocellular carcinoma after radiofrequency ablation
Metformin associated with lower mortality in diabetic patients with early stage hepatocellular carcinoma after radiofrequency ablation
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DOI：
10.1111/j.1440-1746.2011.06664.x
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发表时间：
2011-05-01
影响因子：
4.1
通讯作者：
Wen, Chen-Fan
中科院分区：
文献类型：
--
作者：
Chen, Tsung-Ming;Lin, Chun-Che;Wen, Chen-Fan
背景和目的：2型糖尿病增加癌症发展和死亡的风险。然而，二甲双胍的抗糖尿病治疗可以降低癌症的风险。我们研究了是否二甲双胍用户糖尿病患者与早期肝细胞癌（HCC）进行射频消融（RFA）将有一个有利的生存相比，没有二甲双胍treatment.Methods：共135例早期肝癌患者有162个肿瘤进行RFA。结果：糖尿病患者生存率低于非糖尿病患者（1年82.8%vs 93.9%，3年55.1%vs 80.2%，5年41.3%vs 64.7%，P = 0.004）。在抗糖尿病治疗方面，调整潜在混杂因素后，与未接受二甲双胍治疗的患者相比，二甲双胍使用者的生存结局更好（调整后风险比[HR] 0.24; 95%置信区间[CI]，0.07-0.80; P = 0.020）。磺脲类药物和胰岛素暴露未得出显著结论。对于整个研究人群，包括非糖尿病和糖尿病患者，多变量分析显示，最大肿瘤大小超过2.5 cm（HR，3.49; 95%CI，1.74-6.99; P < 0.001）和未接受二甲双胍治疗的糖尿病患者（HR，3.34; 95%CI，1.67-6.71，P = 0.001）是独立的解释变量与不利的survival.Conclusions：二甲双胍使用者糖尿病肝癌患者接受RFA相比，患者没有二甲双胍治疗有一个有利的总生存率。
Background and Aim:Type 2 diabetes increases the risk of cancer development and mortality. However, antidiabetic treatment with metformin can reduce the risk of cancer. We studied whether metformin users among diabetic patients with early hepatocellular carcinoma (HCC) undergoing radiofrequency ablation (RFA) would have a favorable survival compared with those without metformin treatment.Methods:A total of 135 patients with early stage HCC having 162 tumors underwent RFA. Among them, 53 patients were diabetic, including 21 metformin users and 32 patients without metformin treatment.Results:Diabetic patients had an inferior survival rate compared with nondiabetic patients (1 year, 82.8% vs 93.9%; 3 years, 55.1% vs 80.2%; 5 years, 41.3% vs 64.7%; P = 0.004). With regards to antidiabetic treatments, metformin users had better survival outcome (adjusted hazard ratio [HR] 0.24; 95% confidence interval [CI], 0.07-0.80; P = 0.020) compared to patients without metformin treatment after adjustments for potential confounders. Sulfonylureas and insulin exposures did not achieve significant conclusions. For the whole studied population including nondiabetic and diabetic patients, the multivariate analysis revealed that maximum tumor size more than 2.5 cm (HR, 3.49; 95% CI, 1.74-6.99; P < 0.001) and diabetic patients without metformin treatment (HR, 3.34; 95% CI, 1.67-6.71, P = 0.001) were independent explanatory variables associated with unfavorable survival.Conclusions:Metformin users among diabetic patients with HCC undergoing RFA had a favorable overall survival compared with patients without metformin treatment.