Korean J Gastroenterol.  2012 Dec;60(6):355-361. 10.4166/kjg.2012.60.6.355.

The Effect of Metformin on Responses to Chemotherapy and Survival in Stage IV Colorectal Cancer with Diabetes

• Lee DJ
• Kim B
• Lee JH
• Park SJ
• Hong SP
• Cheon JH
• Kim TI
• Kim WH

• KMID: 1773071
• DOI: http://doi.org/10.4166/kjg.2012.60.6.355

Abstract

BACKGROUND/AIMS
Metformin is known to lower the risk of cancer and cancer mortality. However, the effect of metformin in stage IV colorectal cancer (CRC) patients with diabetes mellitus (DM) remains unknown. The aim of this study was to evaluate the effect of metformin on tumor response and survival in stage IV CRC patients with DM.
METHODS
We identified 106 patients who were diagnosed with both stage IV CRC and DM (81 patients who underwent palliative chemotherapy and 25 patients who underwent curative resection). Retrospective data of each patient's clinical characteristics, tumor response, and survival rate were compared between two groups of patients who either were or were not administered metformin.
RESULTS
For the palliative chemotherapy group, tumor response, change in target lesion size, progression free survival rate, and overall survival rate were not significantly different between the metformin group and the non-metformin group on univariate and multivariate analysis. For the curative resection patient group, metformin use was associated with increased disease free survival on univariate analysis (p=0.012) and multivariate analysis (hazard ratio, 0.024; 95% CI 0.001-0.435; p=0.010), but not with overall survival.
CONCLUSIONS
Metformin use in stage IV CRC patients with diabetes was shown to be associated with a lower risk of tumor recurrence after curative resection.

Keyword

Colorectal neoplasms; Diabetes mellitus; Metformin; Recurrence

MeSH Terms

Adult
Aged
Aged, 80 and over
Antineoplastic Agents/therapeutic use
Colorectal Neoplasms/drug therapy/*mortality/pathology
Diabetes Mellitus/*drug therapy
Disease-Free Survival
Female
Humans
Hypoglycemic Agents/*therapeutic use
Male
Metformin/*therapeutic use
Middle Aged
Multivariate Analysis
Neoplasm Staging
Palliative Care
Retrospective Studies
Survival Rate
Antineoplastic Agents
Hypoglycemic Agents
Metformin

Figure

• 

  Fig. 1 Comparison of progression free survival (A) and overall survival (B) in stage IV colorectal cancer patients with diabetes mellitus who underwent palliative chemotherapy.

• 

  Fig. 2 Comparison of disease free survival according to metformin use in 25 stage IV colorectal cancer (CRC) patients with diabetes mellitus (DM) who underwent curative resection without preoperative chemotherapy (A) and 37 stage IV CRC patients with DM who underwent curative resection with or without preoperative chemotherapy (B).

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