Association between Metformin Use and Survival in Nonmetastatic Rectal Cancer Treated with a Curative Resection
Association between Metformin Use and Survival in Nonmetastatic Rectal Cancer Treated with a Curative Resection: A Nationwide Population Study
Young-Jun Ki, MD1, Hyo Jeong Kim, MPH2, Mi-Sook Kim, MD, PhD3, Chan Mi Park, PhD2, Min Jung Ko, PhD2, Young Seok Seo, MD3, Sun Mi Moon, MD, PhD1, Jin A Choi, MPH2
1Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
2National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
3Department of Radiation Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
Correspondence: Mi-Sook Kim, MD, PhD Department of Radiation Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul 01812, Korea
Tel: 82-2-970-1264 Fax: 82-2-970-2412 E-mail: mskim@kcch.re.kr
Co-Correspondence: Chan Mi Park, PhD National Evidence-based Healthcare Collaborating Agency, Namasan Square (Kukdong B/D) 7F 173 Toegye-ro, Jung-gu, Seoul 04554, Korea
Tel: 82-2-2174-2899 Fax: 82-2-747-4916 E-mail: chpark@neca.re.kr
* Young-Jun Ki and Hyo Jeong Kim contributed equally to this work.
Received March 24, 2016 Accepted June 11, 2016
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Abstract
Purpose
Metformin is associated with an anticancer effect. However, the effects of metformin in rectal cancer are controversial. This study investigated the impact of metformin on the survival of patients with diabetes mellitus and nonmetastatic rectal cancer who underwent curative surgery.
Materials and Methods
The database was provided by the Korea Center Cancer Registry and National Health Insurance Service of the Republic of Korea. A cohort of patients with newly diagnosed rectal cancer between 2005 and 2011 was identified. Drug exposure was defined as receiving the oral hypoglycemic agent for at least 90 days over the period from 6 months before the initial diagnosis of rectal cancer to the last follow-up.
Results
A total of 4,503 patients were prescribed oral hypoglycemic agents and classified as the diabetic group, of which 3,694 patients received metformin for at least 90 days. Unadjusted analyses showed a significantly higher overall survival (hazard ratio, 0.596; 95% confidence interval, 0.506 to 0.702) and rectal cancer-specific survival (hazard ratio, 0.621; 95% confidence interval, 0.507 to 0.760) in the metformin group than in the nonmetformin group. The adjusted overall survival (hazard ratio, 0.631; 95% confidence interval, 0.527 to 0.755) and cancer-specific survival (hazard ratio, 0.598; 95% confidence interval, 0.479 to 0.746) in the group with a medication possession ratio of 80% or greater was significantly higher than in the group with a medication possession ratio of less than 80%.
Conclusion
Metformin use is associated with overall and cancer-specific survival in diabetic patients with a nonmetastatic rectal cancer treated with a curative resection.
http://e-crt.org/journal/view.php?number=2596
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