Abstract
BackgroundMetformin is proven to improve the prognosis of various cancers, but it is unknown if metformin could ameliorate hypopharyngeal cancer in diabetes mellitus patients. This was a retrospective cohort study, and the effect and survival outcome of metformin on hypopharyngeal cancer with diabetes mellitus was investigated.MethodsThere were 141 hypopharyngeal cancer patients collected in a tertiary referral center from December 1st, 2011 to December 31st, 2013. There were 49 patients without diabetes mellitus (DM) and 92 patients with DM. In the 92 DM patients, there were 43 patients with metformin used and 49 patients without metformin used. All received patients followed up until September 1st, 2015.ResultsThere was no significant difference in patients’ characteristics between the non-DM and DM groups, and also no significant difference in clinical T stage, N stage, metastatic condition, and disease stage between the non-DM and DM groups. DM with metformin patients had lower metastasis rates and better overall survival (OS) (p = 0.011) and disease-free survival (DFS) (p = 0.004) compared to non-DM and DM without metformin. Multivariate analysis also showed a better OS and DFS in DM-Met (+) with advanced hypopharyngeal cancer but not in early stage.ConclusionThere was less distant metastasis and better survival outcomes in hypopharyngeal cancer DM patients who use metformin.
Highlights
Metformin is proven to improve the prognosis of various cancers, but it is unknown if metformin could ameliorate hypopharyngeal cancer in diabetes mellitus patients
The survival outcome is still poor after the improvement of surgical techniques or improvement of chemotherapy regiments and radiation technology, even if new trials for hypopharyngeal cancer treatment are ongoing such as cetuximab based radiotherapy (RT) [3] or induction chemotherapy followed by concurrent chemo-radiotherapy (CCRT) or surgery [4, 5]
Study design and data collection The approval of Institutional Review Boards of China Medical University Hospital (No CMUH103-REC1– 078), we reviewed the medical charts who received CCRT for hypopharyngeal cancer
Summary
Metformin is proven to improve the prognosis of various cancers, but it is unknown if metformin could ameliorate hypopharyngeal cancer in diabetes mellitus patients. This was a retrospective cohort study, and the effect and survival outcome of metformin on hypopharyngeal cancer with diabetes mellitus was investigated. Some studies revealed cancer patients with DM have less cancer mortality after anti-glycemic regiment treatment [10, 11]. Literature reported that these patients with combinative metformin treatment has better overall survival and disease survival rate, suggesting potential anticancer roles for metformin [6]. The increased response by metformin treatment was reported in patients with esophagus cancer [16, 17]
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