Jaryl Jun Sheng Cheng1, Huihua Li2, Hui Shan Tan1, Puay Hoon Tan3, Lay Guat Ng4, Quan Sing Ng1, Chee Keong Toh1, Ravindran Kanesvaran1, Min-Han Tan5. 1. Department of Medical Oncology, National Cancer Centre Singapore, Singapore. 2. Department of Health Services Research, Singapore General Hospital, Singapore. 3. Department of Pathology, Singapore General Hospital, Singapore. 4. Department of Urology, Singapore General Hospital, Singapore. 5. Department of Medical Oncology, National Cancer Centre Singapore, Singapore. Electronic address: minhan.tan@gmail.com.
Abstract
PURPOSE: To examine the effect of metformin use on survival outcomes in patients with renal cell carcinoma (RCC). METHODS: Retrospective analysis of 1528 RCC patients from 2 centers between 1992 and 2012 was conducted. A total of 390 diabetics with confirmed metformin use were included in the final analysis, with a median follow-up of 43.1 months. Primary outcomes were disease-free survival (DFS) and cancer-specific survival (CSS). Cox regression models were performed to evaluate the effects of potential predictors on DFS and CSS, following stratification of patients into local and metastatic disease. RESULTS: We identified 290 diabetics with localized and 100 with metastatic RCC. There were no clinicopathologic differences in the profiles of metformin users and non-metformin users. For patients with localized RCC, metformin users had significantly better DFS (hazard ratio, 0.47; P < .01) and CSS (hazard ratio, 0.21; P < .01) than non-users. There was no difference in CSS between metformin users and non-metformin users in diabetics with metastatic RCC (hazard ratio, 0.78; P = .286). Limitations include retrospective design and lack of data on metformin dosage and duration of use. CONCLUSIONS: Metformin use is correlated with improved survival in patients with localized RCC, but not in metastatic RCC. Future studies should focus on its potential mechanisms and clinical utility.
PURPOSE: To examine the effect of metformin use on survival outcomes in patients with renal cell carcinoma (RCC). METHODS: Retrospective analysis of 1528 RCCpatients from 2 centers between 1992 and 2012 was conducted. A total of 390 diabetics with confirmed metformin use were included in the final analysis, with a median follow-up of 43.1 months. Primary outcomes were disease-free survival (DFS) and cancer-specific survival (CSS). Cox regression models were performed to evaluate the effects of potential predictors on DFS and CSS, following stratification of patients into local and metastatic disease. RESULTS: We identified 290 diabetics with localized and 100 with metastatic RCC. There were no clinicopathologic differences in the profiles of metformin users and non-metformin users. For patients with localized RCC, metformin users had significantly better DFS (hazard ratio, 0.47; P < .01) and CSS (hazard ratio, 0.21; P < .01) than non-users. There was no difference in CSS between metformin users and non-metformin users in diabetics with metastatic RCC (hazard ratio, 0.78; P = .286). Limitations include retrospective design and lack of data on metformin dosage and duration of use. CONCLUSIONS:Metformin use is correlated with improved survival in patients with localized RCC, but not in metastatic RCC. Future studies should focus on its potential mechanisms and clinical utility.
Authors: Ondřej Fiala; Pavel Ostašov; Aneta Rozsypalová; Milan Hora; Ondřej Šorejs; Jan Šustr; Barbora Bendová; Ivan Trávníček; Jan Filipovský; Jindřich Fínek; Tomáš Büchler Journal: Cancer Manag Res Date: 2021-05-21 Impact factor: 3.989