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
. 2023 Apr;51(4):3000605231168033.
doi: 10.1177/03000605231168033.

The impact of metformin on survival in diabetes patients with operable colorectal cancer: A nationwide retrospective cohort study

Ping-Teng Chu  1   2   3 , Tzu-Jung Chuang  4 , Shu-Hung Huang  3   5 , Tung-Ho Wu  2 , Wei-Chun Huang  6   7   8 , Jui-Ho Wang  1   9
Affiliations

The impact of metformin on survival in diabetes patients with operable colorectal cancer: A nationwide retrospective cohort study

Ping-Teng Chu et al. J Int Med Res. 2023 Apr.

Abstract

Objective: To investigate the impact of metformin on survival of diabetic patients following surgery for colorectal cancer (CRC).

Methods: This was a retrospective cohort study. From Taiwan's population-based National Health Insurance Research Database (NHIRD) we identified 12,512 patients with CRC and type II diabetes who underwent curative surgery between 2000 and 2012. Of these, 6222 patients were included in a matched cohort. Using Cox regression models with time-dependent covariates we examined the impact of metformin on survival.

Results: Average duration of follow-up was 49 and 54 months for metformin users and non-users, respectively. Cox proportional hazard model showed that metformin was associated with 5-year overall survival benefit (Hazard ratio, 0.23 [95% CI, 0.20-0.26]) and inverse association with risk of liver metastasis (Hazard ratio, 0.79 [95% CI, 0.68-0.93]).

Conclusions: Metformin was associated with a survival benefit in diabetic patients with CRC following surgery, and an inverse association with risk of liver metastases suggesting a potential anti-tumorigenic effect.

Keywords: Metformin; colorectal cancer; diabetes.

PubMed Disclaimer

Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Figure 1.
Figure 1.
Flowchart showing the process of enrolment.
Figure 2.
Figure 2.
Kaplan Meyer curves for 5-year overall survival (OS).
Figure 3.
Figure 3.
Kaplan Meyer curves showing 5-year incidence of liver metastasis.
Figure 4.
Figure 4.
Cox proportional hazard analysis of 5-year overall survival in the matched cohorts. aDCSI, adapted Diabetes Complications Severity Index; CCI, Charlson Comorbidity Index; NTD, New Taiwan Dollars; RT, Radiotherapy; CT, cancer treatment.
Figure 5.
Figure 5.
Cox proportional hazard analysis of 5-year liver metastasis incidence in the matched cohorts. aDCSI, adapted Diabetes Complications Severity Index; CCI, Charlson Comorbidity Index; NTD, New Taiwan Dollars; RT, Radiotherapy; CT, cancer treatment.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Bray F, Ferlay J, Soerjomataram I, et al.. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68: 394–424. - PubMed
    1. Tseng CH.Diabetes but not insulin is associated with higher colon cancer mortality. World J Gastroenterol 2012; 18: 4182–4190. - PMC - PubMed
    1. Fleming M, Ravula S, Tatishchev SF, et al.. Colorectal carcinoma: Pathologic aspects. J Gastrointest Oncol 2012; 3: 153–173. - PMC - PubMed
    1. Vogel JD, Eskicioglu C, Weiser MR, et al.. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Treatment of Colon Cancer. Dis Colon Rectum 2017; 60: 999–1017. - PubMed
    1. Chatterjee S, Khunti K, Davies MJ.Type 2 diabetes. Lancet 2017; 389: 2239–2251. - PubMed

MeSH terms