Association between metformin use after surgery for colorectal cancer and oncological outcomes

A nationwide register-based study

Tina Fransgaard*, Lau Caspar Thygesen, Ismail Gögenur

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Colorectal cancer is one of the most common malignancies in the Western world, and even after surgical removal, there is a high recurrence rate. Metformin treatment has been associated with a reduced risk of developing cancer, but whether metformin influences the risk of recurrence is unknown. The aim of our study was to examine the association between treatment with metformin and recurrence-free, disease-free survival and all-cause mortality after surgery for colorectal cancer. The study was an observational register-based study and included 25,785 patients, of which 1,116 had medically treated diabetes and 966 started metformin treatment at some point postoperatively. Diabetes was not associated with neither disease-free (HRadjusted = 1.09, 95% CI 0.97–1.21, p = 0.15) nor recurrence-free survival (HRadjusted = 1.13, 95% CI 0.95–1.35, p = 0.17). The study found no difference in regards to disease-free or recurrence-free survival between the metformin treated group (HRRFS = 1.06, 95% CI 0.87–1.15, p = 0.57, HRDFS = 1.01, 95% CI 0.89–1.15, p = 0.85) and non-diabetic patients. Patients with diabetes had increased all-cause mortality (HRadjusted = 1.29, 95% CI 1.16–1.45, p < 0.0001). Metformin treatment did not affect all-cause mortality (HR = 1.07, 95% CI 0.94–1.22, p = 0.33) compared to non-diabetic patients. In conclusion, our study did not find an association between diabetes or metformin treatment and recurrence-free or disease-free survival after surgery for colorectal cancer. However, diagnosis of diabetes is associated with increased all-cause mortality.

OriginalsprogEngelsk
TidsskriftInternational Journal of Cancer
Vol/bind143
Udgave nummer1
Sider (fra-til)63-72
ISSN0020-7136
DOI
StatusUdgivet - 1. jul. 2018

Fingeraftryk

Colorectal Neoplasms
Disease-Free Survival
Western World
Neoplasms

Citer dette

@article{77e92e83e8ba4a06852f719b5117a17f,
title = "Association between metformin use after surgery for colorectal cancer and oncological outcomes: A nationwide register-based study",
abstract = "Colorectal cancer is one of the most common malignancies in the Western world, and even after surgical removal, there is a high recurrence rate. Metformin treatment has been associated with a reduced risk of developing cancer, but whether metformin influences the risk of recurrence is unknown. The aim of our study was to examine the association between treatment with metformin and recurrence-free, disease-free survival and all-cause mortality after surgery for colorectal cancer. The study was an observational register-based study and included 25,785 patients, of which 1,116 had medically treated diabetes and 966 started metformin treatment at some point postoperatively. Diabetes was not associated with neither disease-free (HRadjusted = 1.09, 95{\%} CI 0.97–1.21, p = 0.15) nor recurrence-free survival (HRadjusted = 1.13, 95{\%} CI 0.95–1.35, p = 0.17). The study found no difference in regards to disease-free or recurrence-free survival between the metformin treated group (HRRFS = 1.06, 95{\%} CI 0.87–1.15, p = 0.57, HRDFS = 1.01, 95{\%} CI 0.89–1.15, p = 0.85) and non-diabetic patients. Patients with diabetes had increased all-cause mortality (HRadjusted = 1.29, 95{\%} CI 1.16–1.45, p < 0.0001). Metformin treatment did not affect all-cause mortality (HR = 1.07, 95{\%} CI 0.94–1.22, p = 0.33) compared to non-diabetic patients. In conclusion, our study did not find an association between diabetes or metformin treatment and recurrence-free or disease-free survival after surgery for colorectal cancer. However, diagnosis of diabetes is associated with increased all-cause mortality.",
keywords = "cancer epidemiology, colorectal cancer, diabetes mellitus, metformin, recurrence",
author = "Tina Fransgaard and Thygesen, {Lau Caspar} and Ismail G{\"o}genur",
year = "2018",
month = "7",
day = "1",
doi = "10.1002/ijc.31305",
language = "English",
volume = "143",
pages = "63--72",
journal = "International Journal of Cancer",
issn = "0020-7136",
publisher = "JohnWiley & Sons, Inc.",
number = "1",

}

Association between metformin use after surgery for colorectal cancer and oncological outcomes : A nationwide register-based study. / Fransgaard, Tina; Thygesen, Lau Caspar; Gögenur, Ismail.

I: International Journal of Cancer, Bind 143, Nr. 1, 01.07.2018, s. 63-72.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Association between metformin use after surgery for colorectal cancer and oncological outcomes

T2 - A nationwide register-based study

AU - Fransgaard, Tina

AU - Thygesen, Lau Caspar

AU - Gögenur, Ismail

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Colorectal cancer is one of the most common malignancies in the Western world, and even after surgical removal, there is a high recurrence rate. Metformin treatment has been associated with a reduced risk of developing cancer, but whether metformin influences the risk of recurrence is unknown. The aim of our study was to examine the association between treatment with metformin and recurrence-free, disease-free survival and all-cause mortality after surgery for colorectal cancer. The study was an observational register-based study and included 25,785 patients, of which 1,116 had medically treated diabetes and 966 started metformin treatment at some point postoperatively. Diabetes was not associated with neither disease-free (HRadjusted = 1.09, 95% CI 0.97–1.21, p = 0.15) nor recurrence-free survival (HRadjusted = 1.13, 95% CI 0.95–1.35, p = 0.17). The study found no difference in regards to disease-free or recurrence-free survival between the metformin treated group (HRRFS = 1.06, 95% CI 0.87–1.15, p = 0.57, HRDFS = 1.01, 95% CI 0.89–1.15, p = 0.85) and non-diabetic patients. Patients with diabetes had increased all-cause mortality (HRadjusted = 1.29, 95% CI 1.16–1.45, p < 0.0001). Metformin treatment did not affect all-cause mortality (HR = 1.07, 95% CI 0.94–1.22, p = 0.33) compared to non-diabetic patients. In conclusion, our study did not find an association between diabetes or metformin treatment and recurrence-free or disease-free survival after surgery for colorectal cancer. However, diagnosis of diabetes is associated with increased all-cause mortality.

AB - Colorectal cancer is one of the most common malignancies in the Western world, and even after surgical removal, there is a high recurrence rate. Metformin treatment has been associated with a reduced risk of developing cancer, but whether metformin influences the risk of recurrence is unknown. The aim of our study was to examine the association between treatment with metformin and recurrence-free, disease-free survival and all-cause mortality after surgery for colorectal cancer. The study was an observational register-based study and included 25,785 patients, of which 1,116 had medically treated diabetes and 966 started metformin treatment at some point postoperatively. Diabetes was not associated with neither disease-free (HRadjusted = 1.09, 95% CI 0.97–1.21, p = 0.15) nor recurrence-free survival (HRadjusted = 1.13, 95% CI 0.95–1.35, p = 0.17). The study found no difference in regards to disease-free or recurrence-free survival between the metformin treated group (HRRFS = 1.06, 95% CI 0.87–1.15, p = 0.57, HRDFS = 1.01, 95% CI 0.89–1.15, p = 0.85) and non-diabetic patients. Patients with diabetes had increased all-cause mortality (HRadjusted = 1.29, 95% CI 1.16–1.45, p < 0.0001). Metformin treatment did not affect all-cause mortality (HR = 1.07, 95% CI 0.94–1.22, p = 0.33) compared to non-diabetic patients. In conclusion, our study did not find an association between diabetes or metformin treatment and recurrence-free or disease-free survival after surgery for colorectal cancer. However, diagnosis of diabetes is associated with increased all-cause mortality.

KW - cancer epidemiology

KW - colorectal cancer

KW - diabetes mellitus

KW - metformin

KW - recurrence

U2 - 10.1002/ijc.31305

DO - 10.1002/ijc.31305

M3 - Journal article

VL - 143

SP - 63

EP - 72

JO - International Journal of Cancer

JF - International Journal of Cancer

SN - 0020-7136

IS - 1

ER -