Abstract
PurposeThe effects of metformin on the prognosis of kidney cancer patients with diabetes are in controversial. The present study is conducted to classify the association of metformin use with the survival of patients with kidney cancer.MethodsElectronic databases, namely PubMed and Web of Science, were used to search the eligible studies up to December, 2016. Pooled hazard ratio (HR) and its corresponding 95% confidence interval (95% CI) were calculated. It was considered as statistically significant when P value was <0.05.ResultsEight cohorts were eligible for the present meta-analysis, including 254,329 kidney cancer patients. The combined HR suggested that the use of metformin could improve the overall survival (OS) (HR 0.643, 95% CI 0.520–0.795, P < 0.001) and cancer-specific survival (CSS) (HR 0.618, 95% CI 0.446–0.858, P = 0.004) in kidney cancer patients. In subgroup analysis, positive associations were found between metformin use and OS/CSS of localized renal cell carcinoma patients (OS: HR 0.634, 95% CI 0.440–0.913, P = 0.014; CSS: HR 0.476, 95% CI 0.295–0.768, P = 0.002). Moreover, we also found that the use of metformin could reduce the risk of death in kidney cancer patients (HR 0.711, 95% CI 0.562–0.899, P = 0.004).ConclusionOur findings suggest that the use of metformin is in favor of the prognosis of patients with kidney cancers. Further investigations are needed to evaluate the prognostic value of metformin on kidney cancer patients.
Highlights
Renal cell carcinoma (RCC) is recognized as the most common and lethal cancer of kidney cancer, accounting for 85% of all kidney cancers [1, 2]
The criteria for eligible studies were defined as: (1) articles published in English; (2) original studies, not review or meta-analysis; (3) patients diagnosed as kidney cancer patients with diabetes; (4) articles estimating the association between metformin use and survival of kidney cancer patients; (5) eligible data could be obtained including hazard ratio (HR) and 95% confidence interval; exclusion criteria: (1) letters, reviews, and articles not published; (2) articles without the eligible data of either HR or 95% CI
Thirty-two articles were identified in our meta-analysis, of which 18 articles were eliminated at the initial screening of the title and abstract
Summary
Renal cell carcinoma (RCC) is recognized as the most common and lethal cancer of kidney cancer, accounting for 85% of all kidney cancers [1, 2]. Several studies have demonstrated that kidney cancer patients with diabetes mellitus have poorer survival compared with those without diabetes mellitus [4,5,6]. Another three articles found that diabetes mellitus may be an independent risk factor for the survival of kidney cancer patients [7,8,9]. Another study found that compared to metformin non-users, metformin use on RCC patients was in favor of better CSS and DFS
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