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Can metformin change the prognosis of pancreatic cancer? Retrospective study for pancreatic cancer patients with pre-existingdiabetes existingdiabetes mellitus type 2

Authors
 Sang Hoon Lee  ;  Sang Hyun Yoon  ;  Hee Seung Lee  ;  Moon Jae Chung  ;  Jeong Youp Park  ;  Seung Woo Park  ;  Si Young Song  ;  Jae Bock Chung  ;  Seungmin Bang 
Citation
 Digestive and Liver Disease, Vol.48(4) : 435-440, 2016 
Journal Title
 Digestive and Liver Disease 
ISSN
 1590-8658 
Issue Date
2016
MeSH
Adult ; Aged ; Aged, 80 and over ; CA-19-9 Antigen/blood ; Diabetes Mellitus, Type 2/complications* ; Diabetes Mellitus, Type 2/drug therapy* ; Female ; Humans ; Hypoglycemic Agents/therapeutic use* ; Kaplan-Meier Estimate ; Male ; Metformin/therapeutic use* ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; Pancreatic Neoplasms/mortality* ; Pancreatic Neoplasms/pathology* ; Prognosis ; Proportional Hazards Models ; Republic of Korea ; Retrospective Studies ; Survival Rate
Keywords
Biguanide ; Pancreatic adenocarcinoma ; Survival
Abstract
BACKGROUNDS: The effect of metformin on survival in patients with pancreatic cancer is controversial. AIMS: To investigate the beneficial effect of metformin in pancreatic cancer patients. METHODS: We retrospectively analyzed patients with pancreatic cancer and pre-existing diabetes mellitus type 2 who were treated at Severance Hospital (Seoul, South Korea) between May 2005 and December 2013. RESULTS: Among 237 enrolled patients, 117 patients (49.4%) were exposed to metformin. The median overall survival was 13.7 months for the metformin group versus 8.9 months for the non-metformin group (P=0.001) In univariate analysis, metformin exposure, low serum carbohydrate antigen 19-9 levels (<1000 U/mL), small tumor size (≤20 mm), no tail involvement, good performance status (ECOG 0 vs. 1 or 2), and resectable cancer stage were associated with favorable survival outcomes (all P<0.05). In multivariate analysis, in addition to low serum carbohydrate antigen 19-9 levels (<1000 U/mL) and resectable cancer stage, metformin exposure was significantly associated with longer survival with a hazard ratio of 0.61 (P=0.001). Additionally, the cumulative duration of metformin use was significantly correlated with a favorable survival outcome. CONCLUSION: Our findings supported that metformin exposure was associated with survival benefits in patients with pancreatic cancer and pre-existing type 2 diabetes mellitus, especially among those with an advanced cancer stage.
Full Text
http://www.sciencedirect.com/science/article/pii/S1590865815301225
DOI
10.1016/j.dld.2015.12.006
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
박승우(Park, Seung Woo) ORCID logo https://orcid.org/0000-0001-8230-964X
박정엽(Park, Jeong Youp) ORCID logo https://orcid.org/0000-0003-0110-8606
방승민(Bang, Seungmin) ORCID logo https://orcid.org/0000-0001-5209-8351
송시영(Song, Si Young) ORCID logo https://orcid.org/0000-0002-1417-4314
윤상현(Yoon, Sang Hyun)
이희승(Lee, Hee Seung) ORCID logo https://orcid.org/0000-0002-2825-3160
정문재(Chung, Moon Jae) ORCID logo https://orcid.org/0000-0002-5920-8549
정재복(Chung, Jae Bock)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146512
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