Systematic review and meta-analysis of the effect of metformin treatment on overall mortality rates in women with endometrial cancer and type 2 diabetes mellitus
Perez-Lopez, F.R. (Universidad de Zaragoza) ; Pasupuleti, V. ; Gianuzzi, X. ; Palma-Ardiles, G. ; Hernandez-Fernandez, W. ; Hernandez, A.V.
Resumen: Background
Obesity, insulin resistance and type 2 diabetes mellitus (T2DM) have been associated with endometrial cancer (EC). In this systematic review and meta-analysis we evaluated the effect of metformin on clinical outcomes in patients with EC and insulin resistance or T2DM.
Methods
Four research databases were searched for original articles published in all languages up to 30 October 2016. Outcomes of interest were overall mortality (OM), cancer-specific mortality, disease progression, and metastases. We performed a random effect meta-analysis of adjusted effects expressed as hazard ratios (HR); heterogeneity among studies was described with the I2 statistic.
Results
Of the 290 retrieved citations, 6 retrospective cohort studies in women with EC (n = 4723) met the inclusion criteria, and 8.9% to 23.8% were treated with metformin; OM data was available from 5 studies. In 4 studies of EC patients (n = 4132), metformin use was associated with a significant reduction in OM in comparison with not using metformin (adjusted HR [aHR] 0.64, 95% CI 0.45–0.89, p = 0.009). In three studies evaluating patients with EC and T2DM (n = 2637), metformin use was associated with a significant reduction in OM (aHR 0.50, 95%CI 0.34–0.74, p = 0.0006). There was low to moderate heterogeneity of adjusted effects across studies. There was no information about the effect of metformin on cancer-specific mortality, disease progression, or metastases.
Conclusions
Metformin treatment is associated with a significant reduction in OM irrespective of diabetes status in patients with EC. The survival benefit suggests that diabetes screening and maintenance of good glycemic control may improve outcomes in EC.
Idioma: Inglés
DOI: 10.1016/j.maturitas.2017.04.001
Año: 2017
Publicado en: Maturitas 101 (2017), 6-11
ISSN: 0378-5122
Factor impacto JCR: 3.315 (2017)
Categ. JCR: OBSTETRICS & GYNECOLOGY rank: 12 / 81 = 0.148 (2017) - Q1 - T1
Categ. JCR: GERIATRICS & GERONTOLOGY rank: 18 / 53 = 0.34 (2017) - Q2 - T2
Factor impacto SCIMAGO: 1.061 - Obstetrics and Gynecology (Q1) - Biochemistry, Genetics and Molecular Biology (miscellaneous) (Q1)
Tipo y forma: Revisión (PostPrint)
Área (Departamento): Área Obstetricia y Ginecología (Dpto. Cirugía,Ginecol.Obstetr.)
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Obesity, insulin resistance and type 2 diabetes mellitus (T2DM) have been associated with endometrial cancer (EC). In this systematic review and meta-analysis we evaluated the effect of metformin on clinical outcomes in patients with EC and insulin resistance or T2DM.
Methods
Four research databases were searched for original articles published in all languages up to 30 October 2016. Outcomes of interest were overall mortality (OM), cancer-specific mortality, disease progression, and metastases. We performed a random effect meta-analysis of adjusted effects expressed as hazard ratios (HR); heterogeneity among studies was described with the I2 statistic.
Results
Of the 290 retrieved citations, 6 retrospective cohort studies in women with EC (n = 4723) met the inclusion criteria, and 8.9% to 23.8% were treated with metformin; OM data was available from 5 studies. In 4 studies of EC patients (n = 4132), metformin use was associated with a significant reduction in OM in comparison with not using metformin (adjusted HR [aHR] 0.64, 95% CI 0.45–0.89, p = 0.009). In three studies evaluating patients with EC and T2DM (n = 2637), metformin use was associated with a significant reduction in OM (aHR 0.50, 95%CI 0.34–0.74, p = 0.0006). There was low to moderate heterogeneity of adjusted effects across studies. There was no information about the effect of metformin on cancer-specific mortality, disease progression, or metastases.
Conclusions
Metformin treatment is associated with a significant reduction in OM irrespective of diabetes status in patients with EC. The survival benefit suggests that diabetes screening and maintenance of good glycemic control may improve outcomes in EC.
Idioma: Inglés
DOI: 10.1016/j.maturitas.2017.04.001
Año: 2017
Publicado en: Maturitas 101 (2017), 6-11
ISSN: 0378-5122
Factor impacto JCR: 3.315 (2017)
Categ. JCR: OBSTETRICS & GYNECOLOGY rank: 12 / 81 = 0.148 (2017) - Q1 - T1
Categ. JCR: GERIATRICS & GERONTOLOGY rank: 18 / 53 = 0.34 (2017) - Q2 - T2
Factor impacto SCIMAGO: 1.061 - Obstetrics and Gynecology (Q1) - Biochemistry, Genetics and Molecular Biology (miscellaneous) (Q1)
Tipo y forma: Revisión (PostPrint)
Área (Departamento): Área Obstetricia y Ginecología (Dpto. Cirugía,Ginecol.Obstetr.)
Debe reconocer adecuadamente la autoría, proporcionar un enlace a la licencia e indicar si se han realizado cambios. Puede hacerlo de cualquier manera razonable, pero no de una manera que sugiera que tiene el apoyo del licenciador o lo recibe por el uso que hace. No puede utilizar el material para una finalidad comercial. Si remezcla, transforma o crea a partir del material, no puede difundir el material modificado.Exportado de SIDERAL (2019-07-09-11:42:00)
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Registro creado el 2018-12-19, última modificación el 2019-07-09