Metformin Increases Overall Survival in Patients with Diabetes Undergoing Surgery for Colorectal Cancer
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Emerging evidence suggests that metformin decreases the risk of developing colorectal cancer in patients with diabetes, but only few studies have examined potential survival benefits after surgery for colorectal cancer (CRC). The purpose of the study was to examine the association between diabetes and overall survival after resection for CRC. Furthermore, the association between antidiabetic medication and overall survival was examined.
Patients diagnosed with CRC between January 1, 2003 and December 31, 2012 were identified through the Danish Colorectal Cancer Group’s National Clinical Database (DCCG). The Danish National Patient Register (NPR) records all hospital contacts in Denmark, and the diagnosis of diabetes was identified by combining NPR data with use of antidiabetic drugs identified through the Danish National Prescription Registry and DCCG. The Kaplan–Meier estimator and the Cox regression model adjusted for important clinical risk factors were used.
A total of 30,493 patients were included in the study, of which 3391 were diagnosed with diabetes and 1962 were treated with metformin. The adjusted HR of all-cause mortality for the diabetes group was 1.12 (1.06–1.18, p < 0.0001) compared with the nondiabetes group. The adjusted HR was 0.85 (0.73–0.93, p = 0.03) for the metformin-treated group compared with the insulin-treated group.
A 12 % increase in all-cause mortality among patients with CRC and diabetes was found. Treatment with metformin was associated with a 15 % decreased all-cause mortality compared with patients with insulin-treated diabetes.
KeywordsMetformin Antidiabetic Medication Diabetes Mellitus Group National Patient Register Inhibit Cancer Cell Growth
The work was supported by a Grant from Arvid Nilssons Foundation. The authors thank Dr. Sara Kehlet Watt for editing services.
The foundation had no influence on the design or conduct of the study, collection, management, analysis or interpretation of the data or preparation, review or approval of the manuscript.
There are no personal conflicts of interest.
- 7.Danish Colorectal Cancer Database [yearly Report 2013] http://www.dccg.dk/03_Publikation/2013.pdf 2013.
- 12.Sehdev A, Shih YCT, Vekhter B, Bissonnette MB, Olopade OI, Polite BN. Metformin for primary colorectal cancer prevention in patients with diabetes: a case-control study in a U.S. population. Cancer. 2014;121:1–8.Google Scholar
- 16.Garrett CR, Hassabo HM, Bhadkamkar NA, et al. Survival advantage observed with the use of metformin in patients with type II diabetes and colorectal cancer. Br J Cancer. 2012;106(8):1374–8.Google Scholar