Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 May 26;19(5):1295-1302.
doi: 10.22034/APJCP.2018.19.5.1295.

Therapeutic Use of Metformin in Diabetes and Survival Outcomes in Endometrial Cancer Patients with Diabetes

Putsarat Insin  1   2 , Nisa Prueksaritanond
Affiliations

Therapeutic Use of Metformin in Diabetes and Survival Outcomes in Endometrial Cancer Patients with Diabetes

Putsarat Insin et al. Asian Pac J Cancer Prev. .

Abstract

Objectives: To compare survival outcomes between endometrial cancer (EC) patients with diabetes who used metformin to those who did not use metformin. Materials and Methods: A retrospective cohort study was conducted of EC patients who were diabetes at the time of their cancer diagnosis and had been scheduled for elective surgery at Rajavithi Hospital between 1 January 2003 and 31 December 2013. The patients were excluded if they had type I diabetes mellitus and a history of other cancers. Results: Of 1,262 EC patients in the study period, there was 212 (16.8%) patients who met the inclusion criteria. Among them, 90 (42.5%) were non-metformin users and 122 (57.5%) were metformin users. With a median follow-up of 47 months, the 5-year overall survivals (76.4% vs 77.9%, p=0.959) and the 5-year progression-free survivals (92.6% vs 84.7%, p=0.091) did not significantly differ between the both groups. On Cox proportional-hazards regression analysis, independent prognostic factors for overall survival (OS) were FIGO stage, depth of myometrial invasion, and cervical involvement. Patients with non-endometrioid histology and advanced stage were found to have a significant effect on progression-free survival (PFS). However, metformin used did not predict either OS (HR, 0.99; 95%CI, 0.56-1.73; p=0.959) or PFS (HR, 2.19; 95%CI, 0.86-5.55; p=0.099). Conclusion: Overall, a significant effect of metformin on survival outcomes in EC patients with diabetes was not found in the current study. Larger studies with a prospective randomized control design are needed to clarify the benefit of metformin as a strategy for endometrial cancer prevention and treatment.

Keywords: Endometrial cancer; diabetes; metformin; overall survival; progression; free survival.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Kaplan-Meier Curves for Patients with Diabetes Who Used Metformin to Those Who Did not Use Metformin: (A), Overall survival; (B), Progression free-survival
Figure 2
Figure 2
Kaplan-Meier Curves for Overall Survival in EC Patients with Diabetes Who Used Metformin to Those Who Did not Use Metformin with : (A) Endometrioid histology; (B), Non-endometrioid histology.
Figure 3
Figure 3
Kaplan-Meier Curves for Progression-Free Survival in EC Patients with Diabetes Who Used Metformin to Those Who did not Use Metformin with, (A), Endometrioid histology; (B), Non-endometrioid histology.
See this image and copyright information in PMC

References

    1. Abu-Abid S, Szold A, Klausner J. Obesity and cancer. J Med. 2002;33:73–86. - PubMed
    1. American Diabetes Association. Standards of medical care in diabetes 2009. Diabetes Care. 2009;32:13–61.
    1. Calle EE, Rodriquez C, Walker-Thurmond K, et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Eng J Med. 2003;348:1625–38. - PubMed
    1. Cancer in Thailand. Bangkok: Ministry of public health; 2010.
    1. Chin-Hsiao T. Metformin and endometrial cancer risk in Chinese women with type 2 diabetes mellitus in Taiwan. Gynecol Oncol. 2015;138:147–53. - PubMed

MeSH terms