Metformin and survival in pancreatic cancer: a retrospective cohort study.
Metformin and survival in pancreatic cancer: a retrospective cohort study.
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DOI：
10.1097/mpa.0b013e3182965a3c
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发表时间：
2013-10
期刊：
影响因子：
2.9
通讯作者：
Yang YX
中科院分区：
文献类型：
--
作者：
Hwang AL;Haynes K;Hwang WT;Yang YX
我们的目的是确定二甲双胍暴露对晚期胰腺癌（PAC）患者生存率的影响。使用健康改善网络（THIN）进行了一项回顾性队列研究，THIN是一个来自英国的初级保健电子病历数据库（2003 - 2010）。研究队列包括诊断代码为PAC事件且既存诊断为2型糖尿病（T2DM）的所有受试者。如果受试者在PAC诊断前后（之前6个月至之后1个月）接受二甲双胍处方，则将其归类为暴露。仅对暴露受试者进行了次要分析，PAC诊断前6个月）暴露于二甲双胍。主要结局是总生存期。采用单变量和多变量考克斯比例风险模型进行分析。该研究纳入了516例既存T2DM和PAC受试者，其中247例暴露于二甲双胍。在单变量和多变量分析中，在主要分析（HR = 1.11 [0.89，1.38]，p = 0.367）或次要分析（HR = 1.09 [0.80，1.47]，p = 0.585）中，暴露于和未暴露于二甲双胍的患者之间的生存期无差异。二甲双胍的使用与晚期PAC患者生存率的改善无关。
Our aim was to determine the effect of metformin exposure on survival in patients with advanced pancreatic adenocarcinoma (PAC). A retrospective cohort study was conducted using The Health Improvement Network (THIN), a primary care electronic medical record database from the United Kingdom (2003–2010). The study cohort included all subjects with a diagnostic code for incident PAC and a pre-existing diagnosis of type 2 diabetes mellitus (T2DM). Subjects were classified as exposed if they were prescribed metformin around the time of PAC diagnosis (between 6 months prior and 1 month after). A secondary analysis was performed only on exposed subjects without prior (i.e., 6 months before PAC diagnosis) exposure to metformin. The primary outcome was overall survival. The analysis was performed using univariate and multivariable Cox proportional-hazards models. The study included 516 subjects with pre-existing T2DM and PAC, 247 of which were exposed to metformin. In univariate and multivariable analysis, there was no difference in survival between those exposed and those unexposed to metformin in the primary analysis (HR = 1.11 [0.89, 1.38], p = 0.367) or the secondary analysis (HR = 1.09 [0.80, 1.47], p = 0.585). Metformin use is not associated with improved survival in subjects with advanced PAC.