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. 2014 Jan;132(1):236-40.
doi: 10.1016/j.ygyno.2013.10.026. Epub 2013 Nov 2.

Metformin use and endometrial cancer survival

Nicole S Nevadunsky  1 , Anne Van Arsdale  2 , Howard D Strickler  3 , Alyson Moadel  4 , Gurpreet Kaur  2 , Marina Frimer  2 , Erin Conroy  2 , Gary L Goldberg  5 , Mark H Einstein  5
Affiliations

Metformin use and endometrial cancer survival

Nicole S Nevadunsky et al. Gynecol Oncol. 2014 Jan.

Abstract

Objective: Impaired glucose tolerance and diabetes are risk factors for the development of uterine cancer. Although greater progression free survival among diabetic patients with ovarian and breast cancers using metformin has been reported, no studies have assessed the association of metformin use with survival in women with endometrial cancer (EC).

Methods: We conducted a single-institution retrospective cohort study of all patients treated for uterine cancer from January 1999 through December 2009. Demographic, medical, social, and survival data were abstracted from medical records and the national death registry. Overall survival (OS) was estimated using Kaplan-Meier methods. Cox models were utilized for multivariate analysis. All statistical tests were two-sided.

Results: Of 985 patients, 114 (12%) had diabetes and were treated with metformin, 136 (14%) were diabetic but did not use metformin, and 735 (74%) had not been diagnosed with diabetes. Greater OS was observed in diabetics with non-endometrioid EC who used metformin than in diabetic cases not using metformin and non-endometrioid EC cases without diabetes (log rank test (p=0.02)). This association remained significant (hazard ratio=0.54, 95% CI: 0.30-0.97, p<0.04) after adjusting for age, clinical stage, grade, chemotherapy treatment, radiation treatment and the presence of hyperlipidemia in multivariate analysis. No association between metformin use and OS in diabetics with endometrioid histology was observed.

Conclusion: Diabetic EC patients with non-endometrioid tumors who used metformin had lower risk of death than women with EC who did not use metformin. These data suggest that metformin might be useful as adjuvant therapy for non-endometrioid EC.

Keywords: Adjuvant therapy; EC; Endometrial cancer; MMC; Metformin; Montefiore Medical Center; Non-endometrioid; OS; Retrospective cohort study; endometrial cancer; overall survival.

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Conflict of interest statement

There are no conflicts of interest to report.

Figures

Figure 1
Figure 1
Kaplan-Meier curve of overall survival in endometrial cancer patients stratified by diabetes and metformin use among cases with (A) endometrioid histology or (B) non-endometrioid histology
See this image and copyright information in PMC

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