Eun Kyung Jang1, Won Gu Kim2, Hyemi Kwon2, Yun Mi Choi2, Min Ji Jeon2, Tae Yong Kim2, Young Kee Shong2, Won Bae Kim2, Eui Young Kim3. 1. Department of Endocrinology, Dongnam Institute of Radiological and Medical Sciences Cancer Center, Busan, Korea ; Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 2. Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 3. Department of Endocrinology, Dongnam Institute of Radiological and Medical Sciences Cancer Center, Busan, Korea.
Abstract
BACKGROUND AND OBJECTIVE: Type 2 diabetes is known to increase the risk and progression of certain types of cancer. Metformin treatment of diabetic patients is reported to have beneficial effects on some cancers. We evaluated the clinical outcome of diabetic patients with differentiated thyroid cancer (DTC) according to metformin treatment. METHODS: We reviewed 943 patients diagnosed with DTC after total thyroidectomy between 1995 and 2005 in a tertiary hospital. The study involved 60 diabetic patients and 210 control patients matched for age, sex, body mass index (BMI), and tumor size. RESULTS: There were no differences in the clinicopathological features and disease-free survival (DFS) between diabetic patients and the control group over 8.9 years of follow-up. Of the diabetic patients with DTC, 35 patients (58%) were treated with metformin. There were no differences in age, sex, BMI, tumor size, antidiabetic medication, glycated hemoglobin, or C-peptide levels in metformin and nonmetformin groups. However, cervical lymph node (LN) metastasis was more prevalent in the metformin group than in the nonmetformin group (OR 3.52, p = 0.035). Among diabetic patients with cervical LN metastasis of DTC, the metformin subgroup (17.1 years) was associated with longer DFS than the nonmetformin subgroup (8.6 years) (HR 0.16, p = 0.021); metformin treatment was also associated with longer DFS in this subgroup in multivariate analysis after adjusting age, BMI, duration of diabetes, presence of tumor at resection margin, and serum thyroglobulin level at ablation (HR 0.03, p = 0.035). CONCLUSIONS: Metformin treatment is associated with low recurrence in diabetic patients with cervical LN metastasis of DTC.
BACKGROUND AND OBJECTIVE: Type 2 diabetes is known to increase the risk and progression of certain types of cancer. Metformin treatment of diabeticpatients is reported to have beneficial effects on some cancers. We evaluated the clinical outcome of diabeticpatients with differentiated thyroid cancer (DTC) according to metformin treatment. METHODS: We reviewed 943 patients diagnosed with DTC after total thyroidectomy between 1995 and 2005 in a tertiary hospital. The study involved 60 diabeticpatients and 210 control patients matched for age, sex, body mass index (BMI), and tumor size. RESULTS: There were no differences in the clinicopathological features and disease-free survival (DFS) between diabeticpatients and the control group over 8.9 years of follow-up. Of the diabeticpatients with DTC, 35 patients (58%) were treated with metformin. There were no differences in age, sex, BMI, tumor size, antidiabetic medication, glycated hemoglobin, or C-peptide levels in metformin and nonmetformin groups. However, cervical lymph node (LN) metastasis was more prevalent in the metformin group than in the nonmetformin group (OR 3.52, p = 0.035). Among diabeticpatients with cervical LN metastasis of DTC, the metformin subgroup (17.1 years) was associated with longer DFS than the nonmetformin subgroup (8.6 years) (HR 0.16, p = 0.021); metformin treatment was also associated with longer DFS in this subgroup in multivariate analysis after adjusting age, BMI, duration of diabetes, presence of tumor at resection margin, and serum thyroglobulin level at ablation (HR 0.03, p = 0.035). CONCLUSIONS:Metformin treatment is associated with low recurrence in diabeticpatients with cervical LN metastasis of DTC.
Entities:
Keywords:
Diabetes mellitus; Metformin; Neoplasm metastasis; Recurrence; Thyroid cancer
Authors: Sao Jiralerspong; Shana L Palla; Sharon H Giordano; Funda Meric-Bernstam; Cornelia Liedtke; Chad M Barnett; Limin Hsu; Mien-Chie Hung; Gabriel N Hortobagyi; Ana M Gonzalez-Angulo Journal: J Clin Oncol Date: 2009-06-01 Impact factor: 44.544
Authors: Heath D Skinner; Matthew R McCurdy; Alfredo E Echeverria; Steven H Lin; James W Welsh; Michael S O'Reilly; Wayne L Hofstetter; Jaffer A Ajani; Ritsuko Komaki; James D Cox; Vlad C Sandulache; Jeffrey N Myers; Thomas M Guerrero Journal: Acta Oncol Date: 2012-09-05 Impact factor: 4.089
Authors: Craig J Currie; Chris D Poole; Sara Jenkins-Jones; Edwin A M Gale; Jeffrey A Johnson; Christopher Ll Morgan Journal: Diabetes Care Date: 2012-01-20 Impact factor: 19.112
Authors: Yvette J E Sloot; Marcel J R Janssen; Antonius E van Herwaarden; Robin P Peeters; Romana T Netea-Maier; Johannes W A Smit Journal: Sci Rep Date: 2019-04-01 Impact factor: 4.379
Authors: Jian Jin; Sun Woo Lim; Long Jin; Ji Hyun Yu; Hyun Seon Kim; Byung Ha Chung; Chul Woo Yang Journal: Korean J Intern Med Date: 2016-09-30 Impact factor: 2.884